MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Heart Failure Reviews' source. Sat, 20 Mar 2010 13:55:52 +0100 http://www.medworm.com/index.php?rid=3360418&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Faj08552540511724%2F Abstract  Despite a wide range of therapeutic interventions, the prognosis for most patients with heart failure remains poor. The identification of stem cells with the ability to generate cardiomyocytes and vascular cells and promote local repair and survival pathways has highlighted the ability of the heart to undergo regeneration and potentially provides a new therapeutic strategy for treatment of the failing heart. In recent years, however, clinical trials aimed at exploiting the beneficial effects of stem and progenitor cells to treat patients with cardiovascular disease have resulted in mild improvements at best, suggesting that these cells and/or the conditions in which they find themselves are not conducive to cardiac repair. Heart failure is most prevalent among old... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3360418 Thu, 11 Mar 2010 18:24:42 +0100 3360418 http://www.medworm.com/index.php?rid=3355765&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd342417k43702884%2F Abstract  Heart failure is strongly associated with aging. Elderly patients with heart failure often have preserved systolic function exhibiting left ventricular hypertrophy accompanied by a decline in diastolic function. Experimental studies have demonstrated that age-related cardiac fibrosis plays an important role in the pathogenesis of diastolic heart failure in senescent hearts. Reactive oxygen species and angiotensin II are critically involved in fibrotic remodeling of the aging ventricle; their fibrogenic actions may be mediated, at least in part, through transforming growth factor (TGF)-β. The increased prevalence of heart failure in the elderly is also due to impaired responses of the senescent heart to cardiac injury. Aging is associated with suppressed inflammat... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3355765 Wed, 10 Mar 2010 16:17:30 +0100 3355765 http://www.medworm.com/index.php?rid=3355764&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw00ggp55g72t1t31%2F Abstract  Heart disease is important in elderly patients. The treatment of myocardial infarction and heart failure are particularly important and will continue to play an important role across the globe. Advances in treatment of myocardial infarction have made tremendous inroads in the short and long term survival of patients, young and old, however, many currently employed strategies have not been tested in patients who are elderly, who paradoxically, form a growing subset of patients with heart disease. A similar paradigm exists in heart failure for both diagnosis and treatment. Attention to this issue is important when selecting treatment strategies and a focus on the goals of care is critical when decisions for care must be undertaken. Content Type Journal ArticleDO... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3355764 Wed, 10 Mar 2010 16:17:30 +0100 3355764 http://www.medworm.com/index.php?rid=3355766&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F54028752274l4178%2F Abstract  Adiponectin is an adipose tissue-derived adipokine abundant in human plasma. Increasing evidence from experimental studies suggests that adiponectin plays a protective role in the cardiovascular system. However, epidemiological studies revealed that high levels of adiponectin were associated with increased mortality and severity of congestive heart failure. Furthermore, several prospective studies indicated that high levels of adiponectin were positively correlated with increased total and cardiovascular disease mortality in the elderly. These results are completely opposite to our expectation based on the beneficial effects of adiponectin. Clinical observations demonstrated that plasma adiponectin levels were positively associated with B-type natriuretic peptide ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3355766 Wed, 10 Mar 2010 16:17:29 +0100 3355766 http://www.medworm.com/index.php?rid=3240976&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp3242g608g035011%2F Abstract  Cardiovascular disease is one of the leading causes of death in the elderly. Much of the morbidity and mortality in the elderly is attributable to acute ischemic events leading to myocardial infarction (MI) and death of cardiac myocytes. Evidence has been provided that aging associated with adverse remodeling post MI as demonstrated by less effective myocardial repair, greater infarct expansion, and septal hypertrophy. Expression of osteopontin (OPN) increases in the heart post MI. Transgenic mice studies suggest that increased expression of OPN plays a protective role in post-MI LV remodeling by modulating collagen deposition and fibrosis. OPN, a multifunctional protein, has the potential to influence the molecular and cellular changes associated with infarct hea... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3240976 Tue, 02 Feb 2010 17:51:25 +0100 3240976 http://www.medworm.com/index.php?rid=3209632&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb47188u823816454%2F Abstract  Initial research established the feasibility of exercise training in patients with heart failure, as well as associated physiological benefits. This review summarizes the findings from over two dozen single-site studies that address the effect of exercise training on exercise capacity and cardiovascular and peripheral function. In addition, it incorporates the results from two meta-analyses and a recently completed multi-center trial, all of which studied the effects of exercise training on clinical outcomes. The major conclusions from these studies are that exercise training is safe; improves health status and exercise capacity; helps attenuate much of the abnormal pathophysiology that develops with heart failure; and yields a modest reduction in clinical events.... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3209632 Mon, 25 Jan 2010 17:01:05 +0100 3209632 http://www.medworm.com/index.php?rid=3040898&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F745v75961181px24%2F Abstract  Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder caused by the absence of dystrophin, a sarcolemmal protein which links the cytoskeleton to the extracellular matrix by interacting with a large number of proteins. Heart failure is a classic complication of this disease. The authors review the pathogenesis and therapeutics of cardiac involvement in DMD. Content Type Journal ArticleDOI 10.1007/s10741-009-9156-8Authors Abdallah Fayssoil, University of Medicine and Dentistry of New Jersey Camden NJ USAOlivier Nardi, Raymond Poincaré Hospital, AP-HP Intensive Care Unit Garches FranceDavid Orlikowski, Raymond Poincaré Hospital, AP-HP Intensive Care Unit Garches FranceDjillali Annane, Raymond Poincaré Hospital, AP-HP Intensive Care Unit Garches Fran... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3040898 Fri, 27 Nov 2009 07:06:28 +0100 3040898 http://www.medworm.com/index.php?rid=2996831&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe7850u66221u0v76%2F Content Type Journal ArticleCategory Book ReviewDOI 10.1007/s10741-009-9155-9Authors Sidney Goldstein, Wayne State University Detroit MI USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2996831 Fri, 13 Nov 2009 18:28:44 +0100 2996831 http://www.medworm.com/index.php?rid=2947879&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0454480241703821%2F Abstract  Treatment with inotropic agents is one of the most controversial topics in heart failure. Initial enthusiasm, based on strong pathophysiological rationale and apparent empirical efficacy, has been progressively limited by results of controlled trials and registries showing poorer outcomes of the patients on inotropic therapy. The use of these agents remains, however, potentially indicated in a significant proportion of patients with low cardiac output, peripheral hypoperfusion and end-organ dysfunction caused by heart failure. Limitations of inotropic therapy seem to be mainly related to their mechanisms of action entailing arrhythmogenesis, peripheral vasodilation, myocardial ischemia and damage, and possibly due to their use in patients without a clear indicatio... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2947879 Thu, 29 Oct 2009 19:51:20 +0100 2947879 http://www.medworm.com/index.php?rid=2944975&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa85845x1jr061265%2F This article focuses on some of the challenges related to the assessment of RV function in the setting of the RV’s unique anatomic, physiologic, conventional and newer echocardiographic aspects, and therapeutic implications. The majority of proposed methods of echocardiographic assessment of RV function are based on volumetric approximations of the RV. Such approaches have inherent limitations, first as volume-related measures such as EF are load dependent, second because of the complex geometry of the RV. The issue of RV geometry is usually overcome using geometry-independent parameters such as tricuspid annular excursion and the Tei index. The recent introduction of real-time three-dimensional echocardiography and myocardial imaging echocardiography (tissue Doppler imaging, 1D-st... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2944975 Thu, 29 Oct 2009 07:23:04 +0100 2944975 http://www.medworm.com/index.php?rid=2810719&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc8520pn66v3213gu%2F Abstract  It is now becoming clear that two major systems namely the sympathetic nervous system and the renin-angiotensin system are activated in response to ischemic injury; these result in the elevation of plasma catecholamines and angiotensin II during the development of myocardial infarction as well as congestive heart failure. Although plasma levels of several other hormones including aldosterone, endothelin, vasopressin, natriuretic peptides, growth factors and inflammatory cytokines are also increased in heart failure, their relationship with changes in catecholamine and/or angiotensin levels as well as their significance for the induction of congestive heart failure are poorly understood. In this article we have examined the evidence regarding the role of endothelin... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2810719 Fri, 18 Sep 2009 06:15:39 +0100 2810719 http://www.medworm.com/index.php?rid=2810720&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq073162j71m68777%2F Abstract  The normal left ventricular shape has been defined as prolate ellipsoid. This shape is an adaptation to evolution. A knowledge of its unique macro and micro architecture forms the cornerstone in the understanding of its complex function. The left ventricle has a unique architecture with three different myofiber orientations, the longitudinal, circumferential and oblique fibers. The oblique orientation of fibers is essential for effective clockwise and anticlockwise torsional movements during systole and diastole, for optimal ventricular ejection and filling. The orientation and fiber angle decide the shape of the ventricle. An ellipsoid shape is vital for optimal function. Pathological disease states such as ischemic heart disease, valvular heart disease and cardi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2810720 Wed, 16 Sep 2009 12:56:36 +0100 2810720 http://www.medworm.com/index.php?rid=2589479&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyt1164202t140588%2F Content Type Journal ArticleDOI 10.1007/s10741-009-9150-1Authors Howard L. McLeod, University of North Carolina UNC Institute for Pharmacogenomics and Individualized Therapy, Division of Pharmacotherapy and Experimental Therapeutics, Division of Hematology and Oncology, and the Lineberger Comprehensive Cancer Center Campus Box 7360 Chapel Hill NC 27599 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2589479 Mon, 06 Jul 2009 20:13:34 +0100 2589479 http://www.medworm.com/index.php?rid=2564406&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyq782724742267q6%2F Abstract  In this review we investigate the role of particulate and soluble guanylate cyclase (pGC and sGC, respectively) pathways in heart failure, and several novel drugs that modify guanylate cyclase. Nesiritide and ularitide/urodilatin are natriuretic peptides with vasodilating, natriuretic and diuretic effects, acting on pGC, whilst cinaciguat (BAY 58-2667) is a novel sGC activator. Cinaciguat has a promising and novel mode of action because it can stimulate cyclic guanosine-3′,5′-monophosphate synthesis by targeting sGC in its nitric oxide-insensitive, oxidised ferric (Fe3+) or haem-free state. Thus, cinaciguat may also be effective under oxidative stress conditions resulting in oxidised or haem-free sGC refractory to traditional organic nitrate therapies. Prelimin... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2564406 Wed, 01 Jul 2009 06:19:34 +0100 2564406 http://www.medworm.com/index.php?rid=2464908&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa733r173n158r553%2F Abstract  Acute heart failure syndrome (AHFS) is a major public health problem. It is defined as gradual or rapid change in heart failure (HF) signs and symptoms, which often results in an unplanned hospitalization and a need for urgent therapy. Many evidence-based pharmacologic, device, and surgical treatment for HF are available or under development. Despite these new treatments and improvement in survival, hospitalizations in HF have steadily increased over the last 30 years, and the post-discharge prognosis of patients hospitalized with AHFS remains poor (Gheorghiade et al. Circulation 112:3958–3968, 2005; Fonarow et al. Rev Cardiovasc Med 4:S21–30, 2003). Most hospitalizations for AHFS are related to “congestion” rather than to low cardiac output. The defin... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2464908 Sun, 07 Jun 2009 09:03:22 +0100 2464908 http://www.medworm.com/index.php?rid=2448886&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa483583gn126k2uq%2F Abstract  Quantification of left ventricular (LV) systolic function represents a major aspect of echocardiographic assessment in the spectrum of cardiac diseases. However, because of the high complexity of LV contraction mechanics, the classical approach with assessment of a single measure of systolic function, such as ejection fraction or fractional shortening, has been largely superseded. During the last years, through the considerable technical advances in the field of ultrasonography, a number of different echocardiographic methodologies have become available to perform a detailed assessment of different aspects of LV contraction. In particular, evaluation of LV longitudinal systolic dynamics has progressively gained importance as a key aspect in the assessment of LV sy... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2448886 Sat, 30 May 2009 07:49:09 +0100 2448886 http://www.medworm.com/index.php?rid=2418104&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff40025x2q5516647%2F Abstract  Heart failure (HF) is characterized by molecular and cellular defects which jointly contribute to decreased cardiac pump function. During the development of the initial cardiac damage which leads to HF, adaptive responses activate physiological countermeasures to overcome depressed cardiac function and to maintain blood supply to vital organs in demand of nutrients. However, during the chronic course of most HF syndromes, these compensatory mechanisms are sustained beyond months and contribute to progressive maladaptive remodeling of the heart which is associated with a worse outcome. Of pathophysiological significance are mechanisms which directly control cardiac contractile function including ion- and receptor-mediated intracellular signaling pathways. Important... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2418104 Tue, 12 May 2009 06:06:17 +0100 2418104 http://www.medworm.com/index.php?rid=2399754&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc214005l05282127%2F Content Type Journal ArticleDOI 10.1007/s10741-009-9145-yAuthors Kirkwood F. Adams, University of North Carolina at Chapel Hill Departments of Medicine and Radiology, School of Medicine, UNC Heart Failure Program 730 Martin Luther King Jr Blvd Suite 207 Chapel Hill NC 27514 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2399754 Thu, 07 May 2009 06:02:42 +0100 2399754 http://www.medworm.com/index.php?rid=2391253&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm00224k7587m927n%2F Abstract  Advances in genomics and proteomics promise to transform biomarker research, in which the major challenges will not be the discovery of new markers but rather the optimal selection and validation of a subgroup of clinically useful markers from the large pool of candidates. Critically, the value of new biomarkers panels will need to be assessed in the context of readily available clinical information in order to create more actionable knowledge rather than just greater complexity. Appropriate methodologies for the clinical and statistical evaluation of so called “multi-marker strategies” have not been systematically defined. Although specific criteria for the appropriate clinical and statistical evaluation of multi-marker strategies will vary based on the inten... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2391253 Sun, 03 May 2009 05:49:45 +0100 2391253 http://www.medworm.com/index.php?rid=2383493&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr2750682h78l584h%2F Abstract  Given the importance of fibrous tissue in leading to myocardial dysfunction, non-invasive assessment of fibrosis could prove a clinically useful tool in heart failure (HF) patients. Biomarkers may be used for early detection of otherwise subclinical disease, diagnostic assessment of an acute or chronic clinical syndrome, risk stratification of patients with a suspected or confirmed diagnosis, selection of an appropriate therapeutic intervention and monitoring the response to therapy. Extracellular matrix (ECM) biomarkers in HF are promising biomarkers. They are able to detect early changes in heart and large vessel structure and function and transition to HF. High ECM biomarker levels have been associated with poor outcome. The ability of treatment to reduce myoca... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2383493 Thu, 30 Apr 2009 05:58:32 +0100 2383493 http://www.medworm.com/index.php?rid=2370592&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1658484371843510%2F Abstract  Dramatic advances in molecular biology dominated twentieth century biomedical science and delineated the function of individual genes and molecules in exquisite detail. However, biological processes cannot be fully understood based on the properties of individual genes and molecules alone, since these elements act in concert to enable the specific functions that make for living cells and organisms. The discipline of systems biology provides a novel conceptual framework for understanding biological phenomenon. Systems biology synthesizes information concerning the interactions of genes and molecules and allows characterization of the supramolecular networks and functional modules that represent the most essential aspects of cell organization and physiology. Conte... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2370592 Sun, 26 Apr 2009 05:48:39 +0100 2370592 http://www.medworm.com/index.php?rid=2357788&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyh70080650671607%2F Abstract  The management of heart failure remains challenging despite many therapeutic advances. Rigorous clinical trial evidence supports administration of multiple therapies, but utilization of evidence-based treatment remains inconsistent and suboptimal. Disease management programs appear effective, but remain costly and difficult to implement in today’s care system. Another approach involves optimizing therapy based on serial monitoring of cardiac biomarkers. Emerging results suggest that guiding therapy based on serial changes in natriuretic peptides may be an effective strategy. Although pilot work has provided encouraging results, appropriately designed, large-scale, prospective randomized trials are needed to confirm these preliminary findings and definitively est... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2357788 Tue, 21 Apr 2009 04:41:34 +0100 2357788 http://www.medworm.com/index.php?rid=2332056&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F241821722ml6jq65%2F Abstract  Heart failure (HF) is characterized by the elaboration of a portfolio of pro-inflammatory cytokines and inflammatory mediators that are considered to contribute to disease progression by virtue of the deleterious effects that these molecules exert on the heart and circulation. Recent studies have suggested that these inflammatory mediators may serve as relevant markers of disease severity and HF prognosis. Moreover, there is evidence that changes in the levels of inflammatory biomarkers may prove useful in following the change in patient clinical status following institution of appropriate HF therapy. This review will focus on the emerging role of inflammatory biomarkers, including pro-inflammatory cytokines, C-reactive protein, and erythrocyte sedimentation rate ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2332056 Sun, 12 Apr 2009 06:02:11 +0100 2332056 http://www.medworm.com/index.php?rid=2332057&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj4038n616040g023%2F Abstract  N-terminal fragment of pro B-type natriuretic peptide (NT-proBNP) has emerged as an important adjunct in the management of heart failure (HF) and other cardiovascular diseases. NT-proBNP is a 76-amino acid peptide created during cleavage of the precursor molecule, Pro B-type natriuretic peptide (ProBNP). NT-proBNP is of significant diagnostic value in patients presenting with possible HF and is an important prognostic factor in this condition and other cardiovascular diseases. Ongoing research supports the potential value of this biomarker in non-cardiovascular disease. This review will describe clinical applications of NT-proBNP in HF and a broad range of other conditions. Content Type Journal ArticleDOI 10.1007/s10741-009-9142-1Authors Da-Rong Pu, The Second... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2332057 Fri, 10 Apr 2009 06:12:32 +0100 2332057 http://www.medworm.com/index.php?rid=2332058&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa510222528047412%2F Abstract  The B-type natriuretic peptide (BNP) and the amino-terminal fragment of proBNP (NT-proBNP) are increased in heart failure in proportion to severity of symptoms, degree of left ventricular dysfunction, and elevation of cardiac filling pressures. These natriuretic peptides (NPs) are increasingly used for diagnostic and prognostic purposes in acute heart failure. While NP levels on admission provide independent prognostic information, serial determinations during hospitalization and at discharge better reflect adequacy of treatment and prognosis. The addition of BNP and NT-proBNP to usual clinical decision making enhances detection of high-risk patients who need aggressive follow-up and adjustment of treatment. Content Type Journal ArticleDOI 10.1007/s10741-009-914... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2332058 Fri, 10 Apr 2009 06:12:31 +0100 2332058 http://www.medworm.com/index.php?rid=2332059&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh25h677u01544417%2F Abstract  The ability to measure the appearance of cardiac specific forms of troponin in the blood represents a major advance in the clinical assessment of patients with many types of cardiovascular disease, especially acute coronary syndromes. In this review we focus on the utility of troponin in heart failure where this biomarker has emerged as an independent predictor of prognosis providing information beyond clinical assessment and measurement of b-type natriuretic peptides. The novel clinical role of troponin in a variety of states associated with myocardial injury, including chemotherapy and patients with cardiovascular risk factors, is discussed. Content Type Journal ArticleDOI 10.1007/s10741-008-9124-8Authors Almasa Bass, UNC Heart Failure Program School of Phar... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2332059 Sun, 05 Apr 2009 13:02:39 +0100 2332059 http://www.medworm.com/index.php?rid=2221613&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F522m07v878167j31%2F Abstract  Autophagy plays a critical and seemingly dual-purposed role in cardiomyocytes, being implicated as a mechanism of both cellular survival, for example, during ischemia/reperfusion injury and a mechanism of cell death at stages in which progressive myocyte alterations are beyond repair. This review aims to highlight the current literature as it relates to autophagy in cardiomyocytes. It provides background into the mechanisms of cell death, discusses the details that are known about the ubiquitin proteasome system and autophagy, delves into the pathways that are known to initiate and inhibit autophagy, and comments on the role of autophagy in cardiomyocyte homeostasis and cell death. Content Type Journal ArticleDOI 10.1007/s10741-009-9137-yAuthors Pavittarpaul D... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2221613 Wed, 25 Feb 2009 10:09:34 +0100 2221613 http://www.medworm.com/index.php?rid=2215691&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Frw412751646r716t%2F In conclusion, istaroxime is a novel agent being investigated for the treatment of AHFS whose mechanism of action and cellular targets make it a promising therapy. Further studies with longer infusion times in patients with hypotension are required to confirm its efficacy and safety. Content Type Journal ArticleDOI 10.1007/s10741-009-9136-zAuthors Hashim Khan, Northwestern University, Feinberg School of Medicine Chicago IL USAMarco Metra, University of Brescia Department of Cardiology Brescia ItalyJohn E. A. Blair, Northwestern University, Feinberg School of Medicine Chicago IL USAMark Vogel, Northwestern University, Feinberg School of Medicine Chicago IL USAMatthew E. Harinstein, Northwestern University, Feinberg School of Medicine Chicago IL USAGerasimos S. Filippatos, University ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2215691 Tue, 24 Feb 2009 09:37:31 +0100 2215691 http://www.medworm.com/index.php?rid=2215692&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F18214624224x828q%2F Abstract  Stem cell-based therapy for patients with post-infarct heart failure is a relatively new and revolutionary concept in cardiology. Despite the encouraging results from pre-clinical studies, outcomes from most clinical trials remain moderately positive while the clinical benefits are largely attributed to transplanted cell-associated paracrine effects in stimulating angiogenesis and protecting endogenous cardiomyocytes. This scenario indicates that there may be a considerably protracted iterative process of conceptual and procedural refinement before true clinical benefits can be fully materialized. At present, many pressing questions regarding cell therapy remain unanswered. In addition to the primary interest in determining the ideal type of stem cells with best c... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2215692 Tue, 24 Feb 2009 09:37:29 +0100 2215692 http://www.medworm.com/index.php?rid=2209251&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc734206586n1wt0u%2F Abstract  Decreased systolic function is a central factor in the pathogenesis of heart failure, yet there are no safe medical therapies to improve cardiac function in patients. Currently available inotropes, such as dobutamine and milrinone, increase cardiac contractility at the expense of increased intracellular concentrations of calcium and cAMP, contributing to increased heart rate, hypotension, arrhythmias, and mortality. These adverse effects are inextricably linked to their inotropic mechanism of action. A new class of pharmacologic agents, cardiac myosin activators, directly targets the kinetics of the myosin head. In vitro studies have demonstrated that these agents increase the rate of effective myosin cross-bridge formation, increasing the duration and amount of m... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2209251 Sat, 21 Feb 2009 08:11:08 +0100 2209251 http://www.medworm.com/index.php?rid=3097817&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F503440v6k5645u61%2F Abstract  3,5,3′-Triido-l-thyronine (T3) exerts pleiotropic actions on development and homeostasis mostly via its nuclear receptors, TRα1, TRβ1, and TRβ2, encoded by the THRA and THRB genes. Μouse genetics data outline the contrasting functions of THRA and THRB, and suggest that these are dictated by both the respective abundance of the receptor isoforms in a given cell type and the differences in the intrinsic properties of the receptors. The diversity of consequences of either hypothyroidism or THRA/THRB mutation is astonishing, suggesting that TR controls a large number of genes and that the repertoire of target gene differs from one tissue to another. In order to distinguish between the direct and indirect actions of TH in vivo, we use the CRE/LoxP recombinati... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=3097817 Sat, 10 Jan 2009 11:03:22 +0100 3097817 http://www.medworm.com/index.php?rid=2097622&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F503440v6k5645u61%2F Abstract  3,5,3′-Triido-l-thyronine (T3) exerts pleiotropic actions on development and homeostasis mostly via its nuclear receptors, TRα1, TRβ1, and TRβ2, encoded by the THRA and THRB genes. Μouse genetics data outline the contrasting functions of THRA and THRB, and suggest that these are dictated by both the respective abundance of the receptor isoforms in a given cell type and the differences in the intrinsic properties of the receptors. The diversity of consequences of either hypothyroidism or THRA/THRB mutation is astonishing, suggesting that TR controls a large number of genes and that the repertoire of target gene differs from one tissue to another. In order to distinguish between the direct and indirect actions of TH in vivo, we use the CRE/LoxP recombinati... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2097622 Sat, 10 Jan 2009 11:03:22 +0100 2097622 http://www.medworm.com/index.php?rid=2086566&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F37668832840g6n81%2F Abstract  Thyroid hormone exerts a large number of influences on the cardiovascular system. Increased thyroid hormone action increases the force and speed of systolic contraction and the speed of diastolic relaxation and these are largely beneficial effects. Furthermore, thyroid hormone has marked electrophysiological effects increasing heart rate and the propensity for atrial fibrillation and these effects are largely mal-adaptive. In addition, thyroid hormone markedly increases cardiac angiogenesis and decreases vascular tone. These multiple thyroid hormone effects are largely mediated by the action of nuclear based thyroid hormone receptors (TR) the thyroid hormone receptor alpha and beta. TRα is the predominant isoform in the heart. Rapid nongenomic thyroid hormone eff... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2086566 Tue, 06 Jan 2009 16:09:44 +0100 2086566 http://www.medworm.com/index.php?rid=2072959&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F8581121024985045%2F Abstract  The sympathetic nervous system provides the most powerful stimulation of cardiac function, brought about via norepinephrine and epinephrine and their postsynaptic β-adrenergic receptors. More than 30 years after the first use of practolol in patients with heart failure betablockers are now the mainstay of the pharmacological treatment of chronic heart failure. Many aspects of their mechanism of action are well understood, but others remain unresolved. This review focuses on a number of questions that are key to further developments in the field. What accounts for and what is the role of β-adrenergic desensitization, a hallmark of the failing heart? Is part of this adaptation predominantly beneficial and should therefore be reinforced, another part mainly ma... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2072959 Sun, 28 Dec 2008 07:05:44 +0100 2072959 http://www.medworm.com/index.php?rid=2072960&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm78379178q126762%2F Abstract  Thyroid hormone (TH) has a fundamental role in cardiovascular homeostasis in both physiological and pathological conditions, influencing cardiac contractility, heart rate (HR), diastolic function and systemic vascular resistance (SVR) through genomic and non-genomic mediated effects. In heart failure (HF) the main alteration of thyroid function is referred to as “low-triiodothyronine (T3) syndrome” (LT3S) characterized by decreased total serum T3 and free T3 (fT3) with normal levels of thyroxine (T4) and thyrotropin (TSH). Even if commonly interpreted as an adaptive factor, LT3S may have potential negative effects, contributing to the progressive deterioration of cardiac function and myocardial remodeling in HF and representing a powerful predictor of mortalit... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2072960 Sun, 28 Dec 2008 07:05:41 +0100 2072960 http://www.medworm.com/index.php?rid=2064908&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq1t782kw12378071%2F Abstract  Recent studies in various rodent models of pathologic ventricular hypertrophy report the re-expression of deiodinase type 3 (D3) in cardiomyocytes. D3 inactivates thyroid hormone (T3) and is mainly expressed in tissues during development. The stimulation of D3 activity in ventricular hypertrophy and subsequent heart failure is associated with severe impairment of cardiac T3 signaling. Hypoxia-induced signaling appears to drive D3 expression in the hypertrophic cardiomyocyte, but other signaling cascades implicated in hypertrophy are also capable of stimulating transcription of the DIO3 gene. Many cardiac genes are transcriptionally regulated by T3 and impairment of T3 signaling will not only reduce energy turnover, but also lead to changes in gene expression that c... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2064908 Wed, 24 Dec 2008 07:43:09 +0100 2064908 http://www.medworm.com/index.php?rid=2059663&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F586kj33348m11334%2F Abstract  Relaxin is a naturally occurring peptide hormone that plays a central role in the hemodynamic and renovascular adaptive changes that occur during pregnancy. Triggering similar changes could potentially be beneficial in the treatment of patients with heart failure. The effects of relaxin include the production of nitric oxide, inhibition of endothelin, inhibition of angiotensin II, production of VEGF, and production of matrix metalloproteinases. These effects lead to systemic and renal vasodilation, increased arterial compliance, and other vascular changes. The recognition of this has led to the study of relaxin for the treatment of heart failure. An initial pilot study has shown favorable hemodynamic effects in patients with heart failure, including reduction in v... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2059663 Sun, 21 Dec 2008 08:37:09 +0100 2059663 http://www.medworm.com/index.php?rid=2059664&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv106w58n2655m431%2F Abstract  Levosimendan is a new cardiac enhancer that exerts positive inotropic effects on the failing heart mediated by calcium sensitization of contractile proteins as well as peripheral vasodilatory effects mediated by opening of ATP-sensitive potassium channels in vascular smooth-muscle cells. Levosimendan is the most well-studied calcium sensitizer in the real clinical practice, producing greater hemodynamic and symptomatic improvement in patients with acute heart failure syndromes (AHFS) than those with traditional inotropes. Immunomodulatory and anti-apoptotic properties of levosimendan may be an additional biologic mechanism that prevents further cytotoxic and hemodynamic consequences of abnormal immune and neurohormonal responses in AHFS. Recent mortality trials sh... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2059664 Sun, 21 Dec 2008 08:37:06 +0100 2059664 http://www.medworm.com/index.php?rid=2055578&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F35845q193868766w%2F Abstract  This review evaluates the hypothesis that the cardiac effects of amiodarone can be explained—at least partly—by the induction of a local ‘hypothyroid-like condition’ in the heart. Evidence supporting the hypothesis comprises the observation that amiodarone exerts an inhibitory effect on the binding of T3 to thyroid hormone receptors (TR) alpha-1 and beta-1 in vitro, and on the expression of particular T3-dependent genes in vivo. In the heart, amiodarone decreases heart rate and alpha myosin heavy chain expression (mediated via TR alpha-1), and increases sarcoplasmic reticulum calcium-activated ATPase and beta myosin heavy chain expression (mediated via TR beta-1). Recent data show a significant similarity in expression profiles of 8,435 genes in ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2055578 Fri, 19 Dec 2008 08:24:35 +0100 2055578 http://www.medworm.com/index.php?rid=2055579&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft08j651m41323863%2F Abstract  Drugs that inhibit cyclic nucleotide phosphodiesterase activity act to increase intracellular cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) content. In total, 11 families of these enzymes—which differ with respect to affinity for cAMP and cGMP, cellular expression, intracellular localization, and mechanisms of regulation—have been identified. Inhibitors of enzymes in the PDE3 family of cyclic nucleotide phosphodiesterases raise intracellular cAMP content in cardiac and vascular smooth muscle, with inotropic and, to a lesser extent, vasodilatory actions. These drugs have been used for many years in the treatment of patients with heart failure, but their long-term use has generally been shown to increase mortality through mechan... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2055579 Fri, 19 Dec 2008 08:24:31 +0100 2055579 http://www.medworm.com/index.php?rid=2055580&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj28674045kx6k023%2F Abstract  Although we have recently witnessed substantial progress in management and outcome of patients with chronic heart failure, acute heart failure (AHF) management and outcome have not changed over almost a generation. Vasodilators are one of the cornerstones of AHF management; however, to a large extent, none of those currently used has been examined by large, placebo-controlled, non-hemodynamic monitored, prospective randomized studies powered to assess the effects on outcomes, in addition to symptoms. In this article, we will discuss the role of vasodilators in AHF trying to point out which are the potentially best indications to their administration and which are the pitfalls which may be associated with their use. Unfortunately, most of this discussion is only pa... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2055580 Fri, 19 Dec 2008 08:24:27 +0100 2055580 http://www.medworm.com/index.php?rid=2013214&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu0632607rml8ngl3%2F This article will present a brief review of current processes used to diagnose and treat SDB, followed by a discussion of the overlap that exists between CVD and SDB, and present an argument that these chronic conditions should not be considered and managed as separate entities. Content Type Journal ArticleDOI 10.1007/s10741-008-9117-7Authors Robin J. Trupp, The Ohio State University College of Nursing Columbus OH USAElizabeth J. Corwin, The Ohio State University College of Nursing Columbus OH USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2013214 Wed, 03 Dec 2008 08:33:59 +0100 2013214 http://www.medworm.com/index.php?rid=2013213&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu44562167j725668%2F Abstract  The diagnosis and management of heart failure remains challenging despite considerable clinical advances in recent decades. With greater understanding of the pathophysiology of this complex syndrome, a large number of candidate biomarkers have emerged and duly received scientific and clinical attention. These are frequently a measure of the degree of pathophysiological derangement or counter-regulatory processes occurring in heart failure and include biomarkers of neurohormonal activation, myocyte necrosis and myocardial remodelling amongst others. As such they may serve as an indicator of the presence, severity and possibly therapeutic response of the heart failure syndrome and may complement conventional clinical measurements and acumen. This may in turn lead to... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2013213 Wed, 03 Dec 2008 08:33:59 +0100 2013213 http://www.medworm.com/index.php?rid=2013212&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc768802445116710%2F Abstract  Sleep-associated movement disorders are a broad group of sleep disorders characterized by involuntary movements that may disrupt sleep. Relatively little is known about the clinical consequences of sleep-associated movement disorders on cardiovascular health. Because these disorders manifest mostly during sleep, recognizing a movement disorder can be particularly difficult. Nevertheless, patients can have frequent arousals and suffer from similar sleep deprivation, fragmentation, and autonomic disruption as occurs in sleep-disordered breathing. Subsequently, these disorders may have a serious impact on daytime function and perception of health in patients with chronic heart failure. Content Type Journal ArticleDOI 10.1007/s10741-008-9118-6Authors Troy Schaffer... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=2013212 Wed, 03 Dec 2008 08:33:59 +0100 2013212 http://www.medworm.com/index.php?rid=1974415&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ftr4t005h5k7v7144%2F Abstract  3-Iodothyronamine (T1AM) is an endogenous compound derived from thyroid hormone through decarboxylation and deiodination, which interacts with a novel G protein-coupled receptor, known as trace amine-associated receptor 1 (TAAR1). TAAR1 and other receptors of this family are expressed in several tissues, including the heart. Functional effects have been observed after administration of exogenous T1AM: in the isolated heart, a negative inotropic and chronotropic action was produced, and the resistance to ischemic injury was increased, possibly as a consequence of an action on intracellular calcium homeostasis. Extracardiac effects include reduction of body temperature, increased lipid versus carbohydrate metabolism, and modulation of insulin secretion. T1AM might pl... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1974415 Wed, 19 Nov 2008 19:03:25 +0100 1974415 http://www.medworm.com/index.php?rid=1963624&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3472776215k5l170%2F Abstract  Many patients have been characterized harboring a mutation in thyroid hormone receptor (TR) β. Surprisingly none has yet been identified carrying a mutation in TRα1. To facilitate the identification of such patients, several animal models with a mutant TRα1 have been generated. While some phenotypic characteristics, such as an adult euthyroidism, are similar in the mutant mice, other aspects such as metabolism are quite variable. This review summarizes the most important consequences of a mutation in TRα1 in mice focusing on the TRα1-R384C mutation, and projects the insights from the animal models to a putative phenotype of patients with a mutated TRα1. Content Type Journal ArticleDOI 10.1007/s10741-008-9119-5Authors Jens Mittag, Karolinska Institute Dep... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1963624 Fri, 14 Nov 2008 08:06:15 +0100 1963624 http://www.medworm.com/index.php?rid=1954862&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp573462351260p74%2F Abstract  Sobetirome, also known as GC-1 and QRX-431, is a member of a class of compounds known as selective thyromimetics (Scanlan et al., Curr Opin Drug Discov Dev 4:614–622). These compounds are synthetic structural analogs of thyroid hormone that have tissue-specific thyroid hormone actions. Many of the compounds in this class, including sobetirome, also are subtype-selective thyroid hormone receptor (TR) agonists. Sobetirome selectively binds to and activates TRβ over TRα and this receptor selectivity led to the hypothesis that sobetirome would lower cholesterol through activation of liver TRβ without stimulating cardiac function through TRα activation in the heart. The tissue selective thyromimetic properties of sobetirome have been demonstrated in numerous anim... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1954862 Tue, 11 Nov 2008 08:01:33 +0100 1954862 http://www.medworm.com/index.php?rid=1946611&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh2374210293r337k%2F Abstract  The PPAR gene pathway consists of interrelated genes that encode transcription factors, enzymes, and downstream targets which coordinately act to regulate cellular processes central to glucose and lipid metabolism. The pathway includes the PPAR genes themselves, other class II nuclear hormone receptor transcription factors within the PPAR family, PPAR co-activators, PPAR co-repressors, and downstream metabolic gene targets. This review focuses on the transcription factors that comprise the PPAR transcriptional activator complex—the PPARs (PPARα, PPARβ, or PPARγ), PPAR heterodimeric partners, such as RXRα, and PPAR co-activators, such as PPARγ coactivator 1α (PGC-1α) and the estrogen-related receptors (ERRα, ERRβ, and ERRγ). These transcription factors ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1946611 Sun, 09 Nov 2008 10:08:55 +0100 1946611 http://www.medworm.com/index.php?rid=1946612&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F11pn670222271637%2F Abstract  Warfarin remains the drug of choice for long-term anticoagulation management in a variety of conditions. Despite an established role in prevention of thromboembolic events such as stroke, warfarin continues to be underutilized because of its association with serious drug-related adverse events. Lacking alternative therapeutic approaches, intensive research in the past decade has focused on making anticoagulation with warfarin safer. Much emphasis has been placed on defining factors associated with the wide individual variability in warfarin dose. Polymorphic sites in three genes, cytochrome P450 (CYP) 2C9, vitamin K 2,3 epoxide reductase complex 1 (VKORC1), and CYP4F2, have been shown to affect stable warfarin dose. An overview of the persistent issues related to ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1946612 Sun, 09 Nov 2008 10:08:54 +0100 1946612 http://www.medworm.com/index.php?rid=1944949&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F321124h732g20064%2F Content Type Journal ArticleDOI 10.1007/s10741-008-9116-8Authors David J. Whellan, Jefferson Medical College Department of Medicine, Division of Cardiology Philadelphia PA 19017 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1944949 Fri, 07 Nov 2008 08:20:17 +0100 1944949 http://www.medworm.com/index.php?rid=1875585&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj57822626t713322%2F Abstract  Heart failure (HF) is a modern epidemic and is one of the few cardiovascular diseases which is increasing in prevalence. The growing importance of the Natriuretic Peptide (NP) system in HF is well recognized. Laboratory tests for B-type Natriuretic Peptide (BNP) have proven value as diagnostic and prognostic tools in HF and are now part of routine clinical care. Furthermore, recombinant atrial natriuretic peptide (ANP) (carperitide) and BNP (nesiritide) and are approved HF therapies in Japan and the US, respectively and additional natriuretic peptides (e.g., CNP, urodilatin, and designer NPs) are under investigation for use in HF. Common genetic sequence variants are increasingly being recognized as determinants of disease risk or drug response and may help explai... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1875585 Sat, 11 Oct 2008 11:27:42 +0100 1875585 http://www.medworm.com/index.php?rid=1814964&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy34t0518661428q0%2F Abstract  Obstructive sleep apnea (OSA) is increasingly recognized as a novel cardiovascular risk factor. OSA is implicated in the pathogenesis of hypertension, left ventricular dysfunction, coronary artery disease and stroke. OSA exerts its negative cardiovascular consequences through its unique pattern of intermittent hypoxia. Endothelial dysfunction, oxidative stress, and inflammation are all consequences of OSA directly linked to intermittent hypoxia and critical pathways in the pathogenesis of cardiovascular disease in patients with OSA. This review will discuss the known mechanisms of vascular dysfunction in patients with OSA and their implications for cardiovascular disease. Content Type Journal ArticleDOI 10.1007/s10741-008-9112-zAuthors Rami Khayat, The Ohio St... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1814964 Sat, 20 Sep 2008 10:16:57 +0100 1814964 http://www.medworm.com/index.php?rid=1782104&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn248p1742j32l5k0%2F Abstract  Hyponatremia is independently associated with adverse outcomes in patients with congestive heart failure (CHF). The primary cause of hyponatremia in CHF is the inappropriate secretion of the antidiuretic hormone, arginine vasopressin (AVP). The binding of AVP to V2 receptors in the renal collecting duct promotes water retention, a process that can lead to dilutional hyponatremia as well as increased ventricular preload. AVP could also exacerbate the course of CHF by interacting with V1A receptors on vascular smooth muscle cells and myocytes. Conventional treatment of hyponatremia in CHF is based largely on water restriction, which is neither effective nor well tolerated. Current research is exploring V2- and dual V1A/V2-receptor antagonism for the treatment of hypon... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1782104 Tue, 09 Sep 2008 00:21:07 +0100 1782104 http://www.medworm.com/index.php?rid=1775021&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F148445g2hv141195%2F Abstract  Viable myocardium undergoes several changes in the course of cardiac remodeling following myocardial infarction aiming to adapt the heart to the hemodynamic compromise. This response is characterized by reactivation of the fetal transcriptional program and results in cardiac dysfunction. Changes in thyroid hormone (TH)-TH receptors (TRs) axis occur in the course of post-infarction cardiac remodeling and seem to contribute to cardiac fetal phenotype. TH can “rebuild” the post-infarcted heart by preventing the fetal-like pattern of contractile proteins expression, normalizing wall tension, and optimizing cardiac chamber geometry. This effect seems to be attributed to TH pleiotropic cellular actions; TH promotes tissue growth and differentiation and favorably rem... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1775021 Fri, 05 Sep 2008 17:50:35 +0100 1775021 http://www.medworm.com/index.php?rid=1763498&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh42386k06h2t226v%2F Abstract  In the Adhere (Acute Decompensated Heart Failure Registry) National Registry, hyponatremia (serum sodium <130 mEq/l) at clinical presentation was noted in 5% of patients with HF. The enhanced release of arginine vasopressin (AVP) can lead to hyponatremia by binding to the V2 receptor results in free-water retention and hyponatremia. Given the central role of AVP in causing hyponatremia in patients with congestive heart failure, decreasing vasopressin activity has been a therapeutic focus. With no current therapy to decrease production of AVP, attention was turned to decreasing the effect of AVP by blocking the receptor. Content Type Journal ArticleDOI 10.1007/s10741-008-9107-9Authors Siva K. Kumar, Jefferson Medical College Thomas Jefferson Univers... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1763498 Wed, 03 Sep 2008 08:45:19 +0100 1763498 http://www.medworm.com/index.php?rid=1763497&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F237538r375r5w186%2F Abstract  Congestive heart failure (CHF) is characterized by fluid and water retention, which frequently is a therapeutic challenge. Most conventional diuretics act primarily as saluretics, i.e. they inhibit renal tubular electrolyte reabsorption, which due to osmotic pressure promotes excretion of isotonic fluid. Arginine vasopressin (AVP) via the V1A receptor vasoconstricts and via the V2 receptor promotes water reabsorption in the renal collecting duct by inserting aquaporin-2 water channels into the luminal membrane. Novel V2 receptor antagonists act as powerful aquaretics, i.e. they excrete free water. We review the pharmacology of non-selective V1A/V2 receptor antagonists and selective V2 receptor antagonists currently in clinical development. Content Type Journal Ar... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1763497 Wed, 03 Sep 2008 08:45:19 +0100 1763497 http://www.medworm.com/index.php?rid=1749784&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy5h54811276n7v22%2F This article reviews insomnia in CHF, cardiac medication side-effects related to sleep disturbances, and treatment options. Content Type Journal ArticleDOI 10.1007/s10741-008-9102-1Authors Don Hayes, University of Kentucky College of Medicine J410 Kentucky Clinic Departments of Pediatrics and Internal Medicine 740 South Limestone Street Lexington KY 40536 USAMichael I. Anstead, University of Kentucky College of Medicine J410 Kentucky Clinic Departments of Pediatrics and Internal Medicine 740 South Limestone Street Lexington KY 40536 USAJulia Ho, University of Kentucky HealthCare Department of Pharmacy 800 Rose Street H-110 Lexington KY 40536-0293 USABarbara A. Phillips, University of Kentucky, Samaritan Sleep Center Department of Internal Medicine 310 South Limestone Street Lexington... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1749784 Sat, 30 Aug 2008 11:03:23 +0100 1749784 http://www.medworm.com/index.php?rid=1749787&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe03m1045q313u675%2F Content Type Journal ArticleDOI 10.1007/s10741-008-9106-xAuthors Kanu Chatterjee, UCSF Norwich CT USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1749787 Sat, 30 Aug 2008 11:03:22 +0100 1749787 http://www.medworm.com/index.php?rid=1749786&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn68u64612n8w9782%2F Abstract  Hyponatremia is the most common electrolyte abnormality found in hospitalized patients with heart failure. It may occur in patients who have hypovolemic, hypervolemic, or euvolemic state. It is usually not corrected by available therapies. It is a major predictor of prognosis, and correction of hyponatremia can be effectively accomplished by vasopressin antagonists. However, it still remains to be seen whether the normalization of serum sodium with vasopressin antagonists will also lead to an improved long-term prognosis. Content Type Journal ArticleDOI 10.1007/s10741-008-9109-7Authors Dimitrios Farmakis, Attikon University Hospital Second Department of Cardiology, Heart Failure Unit Athens GreeceGerasimos Filippatos, Attikon University Hospital Second Departme... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1749786 Sat, 30 Aug 2008 11:03:22 +0100 1749786 http://www.medworm.com/index.php?rid=1749785&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff566165v44221683%2F Abstract  Obstructive sleep apnea (OSA), present in 5–15% of adults, is strongly associated with the incidence and poor outcome of hypertension, coronary artery disease, arrhythmia, heart failure, and stroke. Treatment of OSA completely reverses its cardiovascular consequences. In this review, we discuss the clinical evidence for the strong association between OSA and cardiovascular disease and present an argument for approaching OSA as a cardiovascular disease. We particularly focus on the causative relationship between OSA and hypertension, and on the increasingly recognized relationship between OSA and heart failure. Content Type Journal ArticleDOI 10.1007/s10741-008-9101-2Authors Kiran Devulapally, Ohio State University Division of Pulmonary, Critical Care, and Sle... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1749785 Sat, 30 Aug 2008 11:03:22 +0100 1749785 http://www.medworm.com/index.php?rid=1749789&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5r433w2720361571%2F This article will review the determinants of central apnea, the specific features of CHF-related central apnea, and outline a management approach Content Type Journal ArticleCategory Apnea in Heart FailureDOI 10.1007/s10741-008-9100-3Authors Safwan Badr, Wayne State University Detroit USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1749789 Sat, 30 Aug 2008 11:03:21 +0100 1749789 http://www.medworm.com/index.php?rid=1749788&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm001661r70p26888%2F Abstract  Diastolic dysfunction is frequent in elderly subjects and in patients with left ventricular hypertrophy, vascular disease and diabetes mellitus. Patients with diastolic dysfunction demonstrate a reduced exercise capacity and might suffer from congestive heart failure (CHF). Presence of symptoms of CHF in the setting of a normal systolic function is referred to as heart failure with normal ejection fraction (HFNEF) or, if evidence of an impaired diastolic function is observed, as diastolic heart failure (DHF). Reduced exercise capacity in diastolic dysfunction results from a number of pathophysiological alterations such as slowed myocardial relaxation, reduced myocardial distensibility, elevated filling pressures, and reduced ventricular suction forces. These alter... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1749788 Sat, 30 Aug 2008 11:03:21 +0100 1749788 http://www.medworm.com/index.php?rid=1749790&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv7p773024110t191%2F Abstract  Sleep-disordered breathing (SDB) has a higher prevalence in patients with heart failure than in the general middle-aged population. Obstructive sleep apnea (OSA), one of the forms of SBD, promotes poorly controlled hypertension, coronary events, and atrial fibrillation events that can lead to acutely decompensated heart failure (ADHF), and evidence suggests that untreated OSA increases mortality in patients with heart failure. Cheyne–Stokes respiration and central sleep apnea (CSA) have long been associated with heart failure and, in many patients, can coexist with OSA. In this article, we propose a systematic approach to diagnose and treat OSA in patients with ADHF based on current evidence. Content Type Journal ArticleDOI 10.1007/s10741-008-9103-0Authors M... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1749790 Sat, 30 Aug 2008 11:03:20 +0100 1749790 http://www.medworm.com/index.php?rid=1723017&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx1088u466l355254%2F Abstract  Our understanding of the multiple in vivo functions of the proinflammatory cytokine, tumor necrosis factor (TNFα), is advancing at a rapid pace. In addition to its antitumor effects, overproduction of TNFα provokes tissue injury and organ failure. TNFα has also been shown to be cardiodepressent and responsible for various cardiovascular complications. It appears that still much needs to be learned for a full comprehension of the role of TNFα in heart biology. Another cytokine, interleukin-10 (IL-10), has been shown to have anti-inflammatory properties. It is suggested to counterbalance many adverse effects of TNFα. IL-10 suppresses the production of TNFα and many other proinflammatory cytokines. TNFα-induced oxidative stress is also known to be mitigated by... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1723017 Tue, 19 Aug 2008 17:24:52 +0100 1723017 http://www.medworm.com/index.php?rid=1615225&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj7t3337081204113%2F Abstract  In patients with congestive heart failure, sleep disordered breathing occurs commonly and is associated with an increased mortality. In addition to central sleep apnea (Cheyne–Stokes respiration), obstructive sleep apnea is more prevalent in patients with congestive heart failure than in the general population. As a result, a number of treatments have been investigated, with varying results. While many therapies may improve the severity of sleep disordered breathing, only positive pressure ventilation has been shown to improve cardiac function. Newer forms of positive pressure ventilation, such as adaptive servo-ventilation, appear to be even more effective at correcting central sleep apnea. Whether any of these treatments have an effect on transplant-free survi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1615225 Fri, 11 Jul 2008 07:25:43 +0100 1615225 http://www.medworm.com/index.php?rid=1518070&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F038037u761257l08%2F Abstract  Heart failure is a growing problem, placing an increasing burden on public health resources and continuing to exert a high toll in mortality and morbidity. Sleep disordered breathing (SDB) is also a major public health problem and is associated with an increased risk of fatal and non-fatal cardiovascular events. Current evidence suggests SDB, particularly central SDB, is more prevalent in patients with chronic heart failure (CHF) than in the general population, but is under-diagnosed as SDB symptoms are less prevalent in CHF. This is further hampered by the absence of a simple and accurate screening tool and limited access to sleep facilities to diagnose SDB in the large numbers of patients with CHF. The presence of SDB in patients with CHF imposes increased haemo... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1518070 Thu, 12 Jun 2008 06:28:30 +0100 1518070 http://www.medworm.com/index.php?rid=1518071&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy7720261812u08w2%2F Abstract  Mechanical circulatory support (MCS) devices are a guideline-recommended treatment option for a small subset of advanced heart failure patients. MCS has the potential to become more prominent in the management of Acute Heart Failure Syndromes (AHFS) as device technology advances and as clinical trials consistently discover neutral or harmful effects with pharmacologic therapies hypothesized to be beneficial in this population. While it is now possible to identify AHFS patients who are at high risk of death, the therapeutic options available to improve their long-term outcomes are limited. MCS therapy in this population offers a “bridge to recovery” strategy; these patients may have viable myocardium that responds favorably to the influence of MCS on neurohormo... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1518071 Thu, 12 Jun 2008 06:28:28 +0100 1518071 http://www.medworm.com/index.php?rid=1401973&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl73325vm14736210%2F This article discusses the prospect of genomic science as an approach to the identification of patients at high-risk for SCD. While the final common pathway for SCD is malignant ventricular arrhythmias, there are many potential contributors, pathways, and mechanisms by which common genetic variants (polymorphisms) could affect initiation and propagation of life-threatening cardiac arrhythmias. Recent advances in genomic medicine now provide us with novel approaches to both identify candidate genes/pathways and relatively common polymorphisms which may predispose patients to increased risk for SCD. Improved understanding of the relationship between common polymorphisms and SCD will not only improve risk stratification such that ICDs can be targeted to those patients most likely to ben... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1401973 Fri, 25 Apr 2008 10:18:03 +0100 1401973 http://www.medworm.com/index.php?rid=1401974&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc4710p0507m67734%2F Abstract  β-Blockers (metoprolol, bisoprolol, and carvedilol) are a cornerstone of heart failure (HF) treatment. However, it is well recognized that responses to a β-blocker are variable among patients with HF. Numerous studies now suggest that genetic polymorphisms may contribute to variability in responses to a β-blocker, including left ventricular ejection fraction improvement, survival, and hospitalization due to HF exacerbation. This review summarizes the pharmacogenetic data for β-blockers in patients with HF and discusses the potential implications of β-blocker pharmacogenetics for HF patients. Content Type Journal ArticleDOI 10.1007/s10741-008-9094-xAuthors Jaekyu Shin, University of Florida Department of Pharmacy Practice, College of Pharmacy, Center for Ph... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1401974 Fri, 25 Apr 2008 10:18:00 +0100 1401974 http://www.medworm.com/index.php?rid=1366456&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpg4166420t386548%2F Abstract  Epidemiologic observations showing associations between higher levels of some biologic markers such as blood pressure and serum cholesterol with heightened risk of death and non-fatal cardiovascular events have provided important data to develop hypotheses regarding pharmacologic therapies to modify these markers to improve prognosis. Randomized controlled trials have shown that strategies to reduce blood pressure with a variety of antihypertensive agents and LDL cholesterol with statins do, indeed, result in important improvements in clinical outcomes. However, there are several instances where a hypothesis based on strong observational data has been rejected based on surprising counterintuitive evidence generated from randomized controlled clinical trials. Use o... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1366456 Thu, 10 Apr 2008 07:06:06 +0100 1366456 http://www.medworm.com/index.php?rid=1362244&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc8273377823p70k4%2F Abstract  An association between anaemia, poor functional status and, compared to non-anaemic patients, worse clinical status and a higher risk of hospitalisation and death has been consistently reported in chronic heart failure (CHF), although cause an effect has not been proven. While it is attractive to think that correction of a co-morbidity that exacerbates already diminished delivery of oxygen to the tissues in heart failure is likely to beneficial, the possible haemodynamic effects of increasing haemoglobin, for example vasoconstriction, might not be. Consequently, the balance of benefit and risk of anaemia correction in CHF is uncertain, may vary according to the severity of anaemia (and other factors) and needs to be properly evaluated. To date, most studies of ana... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1362244 Tue, 08 Apr 2008 07:19:46 +0100 1362244 http://www.medworm.com/index.php?rid=1339952&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq021083q50520j10%2F Content Type Journal ArticleDOI 10.1007/s10741-008-9093-yAuthors Inder Anand, University of Minnesota Medical School Minneapolis MN 55417 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1339952 Sat, 29 Mar 2008 09:00:27 +0100 1339952 http://www.medworm.com/index.php?rid=1339953&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg6w03234706m4066%2F Abstract  Although there is a large body of knowledge on protein synthesis, the available data on protein catabolism, although quite substantial, are still inadequate. This is due to the marked differences in the activity of proteolytic enzymes, compounded by different substrate specificities and multiple environmental factors. Understanding enzyme behavior under physiological and pathological conditions requires the identification of specific proteolytic activities, such as aminopeptidases, as able to degrade certain peptidergic hormones or neuropeptides. Another requirement is the isolation, purification and characterization of the enzymes involved. In addition, systematic studies are needed to determine each enzyme’s subcellular location, tissue distribution, and the i... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1339953 Sat, 29 Mar 2008 09:00:26 +0100 1339953 http://www.medworm.com/index.php?rid=1334351&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx2064l57v560u630%2F Abstract  Heart failure affects millions of Americans and new diagnosis rates are expected to almost triple over the next 30 years as our population ages. Affective disorders including clinical depression and anxiety are common in patients with congestive heart failure. Furthermore, the presence of these disorders significantly impacts quality of life, medical outcomes, and healthcare service utilization. In recent years, the literature has attempted to describe potential pathophysiologic mechanisms relating affective disorders and psychosocial stress to heart failure. Several potential mechanisms have been proposed including autonomic nervous system dysfunction, inflammation, cardiac arrhythmias, and altered platelet function. These mechanisms are reviewed in this art... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1334351 Thu, 27 Mar 2008 18:38:35 +0100 1334351 http://www.medworm.com/index.php?rid=1328742&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh566428607070279%2F Abstract  The biology of iron in relation to anemia is best understood by a review of the iron cycle, since the majority of iron for erythropoiesis is provided by iron recovered from senescent erythrocytes. In iron-deficiency anemia, storage iron declines until iron delivery to the bone marrow is insufficient for erythropoiesis. This can be monitored with clinical indicators, beginning with low plasma ferritin, followed by decreased plasma iron and transferrin saturation, and culminating in red blood cells with low-Hb content. When adequate dietary iron is provided, these markers show return to normal, indicating a response to the dietary supplement. Anemia of inflammation (also known as anemia of chronic disease, or ACD) follows a different course, because in this form of ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1328742 Tue, 25 Mar 2008 07:12:39 +0100 1328742 http://www.medworm.com/index.php?rid=1319017&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F600936534261g0m1%2F Abstract  Blockade of the renin–angiotensin–aldosterone system (RAAS) with ACE inhibitors has been a cornerstone of heart failure therapy for over 15 years. More recently, further blockade of RAAS with aldosterone antagonists and angiotensin receptor blockers (ARBs) has been studied. While these therapies have certainly improved outcomes in the treatment of heart failure, morbidity and mortality remain extremely high. Furthermore, polypharmacy and complex regimens of seven medications on average is the norm for management of heart failure. This results in increased costs, patient burden, and uncertainty as to the best course of therapy. The ability to personalize patients’ therapeutic regimens using pharmacogenomics has the potential of providing more effective a... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1319017 Thu, 20 Mar 2008 09:33:13 +0100 1319017 http://www.medworm.com/index.php?rid=1313879&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc31221q8142mh82k%2F Abstract  End-stage heart failure is characterized by a number of abnormalities at the cellular level, which include changes in excitation–contraction coupling, alterations in contractile proteins and activation/deactivation of signaling pathways. Even though many of these changes are adaptive to the high workload and stress in heart failure, a significant number of these alterations are deeply deleterious to the cardiac cell. In this article, we will review the changes in calcium cycling that occur in myopathic hearts and how they can be effectively targeted. We will also focus on protein misfolding in the setting of cardiac dysfunction. Content Type Journal ArticleDOI 10.1007/s10741-007-9071-9Authors Federica del Monte, Beth Israel Deaconess Medical Center Cardiovasc... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1313879 Tue, 18 Mar 2008 07:58:45 +0100 1313879 http://www.medworm.com/index.php?rid=1217729&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk0317858r56v0504%2F This article reviews the potential impact of pleiotropic effects of some prototypic cardiac drugs such as renin-angiotensin-aldosterone system (RAAS) inhibitors, statins, and thrombolytics during healing post-ST-segment-elevation MI (STEMI), with special focus on inflammation, ECCM and remodeling, and implications in the elderly. Content Type Journal ArticleDOI 10.1007/s10741-008-9090-1Authors Bodh I. Jugdutt, University of Alberta Division of Cardiology, Department of Medicine and Cardiovascular Research Group, Faculty of Medicine Edmonton Canada Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1217729 Thu, 07 Feb 2008 18:17:13 +0100 1217729 http://www.medworm.com/index.php?rid=1197910&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F67088u8309401873%2F Abstract  This review article summarizes the current medical literature reporting on the prevalence and prognostic significance of anemia in patients with heart failure. Almost all currently available data indicate that anemia is common in heart failure populations, with the majority of studies indicating prevalence >20%. Anemia appears to be more highly prevalent in patients with advanced age, with more severe limitations in functional capacity, and with greater severity of co-morbid chronic kidney disease. In most reported studies anemia is an independent predictor of increased mortality risk and increased risk of hospitalization for heart failure. These data provide the rationale for interventional treatment trials to determine if anemia is in the causal pathway for d... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1197910 Sat, 02 Feb 2008 16:50:07 +0100 1197910 http://www.medworm.com/index.php?rid=1195770&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff1567xr04669167r%2F Abstract  Anemia is a common comorbidity in patients with heart failure and affects up to 50% of patients, depending on the definition of anemia used and on the population studied. Presence of anemia and lower hemoglobin (Hgb) concentrations are powerful independent predictors of adverse outcomes in heart failure. Even small reductions in Hgb are associated with worse outcomes. Correction of anemia may be useful in improving heart failure outcomes. However, the causes of anemia in heart failure are not entirely clear. Specific causes of anemia such as hematinic abnormalities are seen only in a minority of subjects. Renal dysfunction and neurohormonal and proinflammatory cytokine activation appear to contribute to anemia of chronic disease in the majority of the patients, re... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1195770 Thu, 31 Jan 2008 15:50:55 +0100 1195770 http://www.medworm.com/index.php?rid=1195769&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7j11x433m7378390%2F Abstract  Erythropoietin, the primary regulator of erythropoiesis, is produced by the kidney and levels vary inversely with oxygen availability. Hypoxia-inducible factor-1 (HIF-1), a major transcriptional regulator of several hypoxia-sensitive genes, including erythropoietin, is functionally deactivated by oxygen in a reaction catalyzed by prolyl hydroxylase. Erythropoietin acts by binding to a specific trans-membrane dimeric receptor which has been found in erythroid and non-erythroid cell types. The interaction between erythropoietin and its receptor ultimately leads to conformational change and phosphorylation of the receptor and expression of genes coding for proteins that are anti-apoptotic. Development of erythropoietin stimulating agents is an area of active research.... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1195769 Thu, 31 Jan 2008 15:50:54 +0100 1195769 http://www.medworm.com/index.php?rid=1195768&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fxkq2371v51168g42%2F Abstract  Erythropoietin (EPO) is not solely a hormone charged with regulating the proliferation and differentiation of erythroid cells. Indeed, EPO is synthesized locally by many cells, especially under conditions of stress or injury. In these paracrine/autocrine settings, EPO plays a crucial protective–restorative role, activating cytoprotection (e.g., in the brain, heart, and kidney), reducing inflammatory responses, preserving vascular integrity, and mobilizing stem cells, including proliferation and differentiation of endothelial progenitor cells. EPO administration prevents cardiac myocyte apoptosis and decreases infarct size in several studies using rodent models of myocardial infarction. Recently, some key steps of the signaling pathways by which EPO confers cardi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1195768 Thu, 31 Jan 2008 15:50:54 +0100 1195768 http://www.medworm.com/index.php?rid=1191086&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw02k38831757rt6t%2F Abstract  Patients diagnosed with CHF have disproportionately high rates of depression. Research has demonstrated significant consequences of depression in patients with CHF including poor quality of life, worse medical adherence and increased health complications, health care utilization, and medical costs. Despite these consequences, the treatment of depression in patients with CHF has not been widely explored. In fact, a review of the literature demonstrates a clear gap when it comes to efficacious treatments of depression in patients afflicted with CHF. The present article introduces the empirically supported therapy ‘cognitive behavioral therapy’ (CBT) and provides information about the literature supporting the use of CBT in depressed patients. Finally, the presen... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1191086 Tue, 29 Jan 2008 15:49:14 +0100 1191086 http://www.medworm.com/index.php?rid=1184304&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr12134h328003485%2F Abstract  Heart failure (HF) is a major problem worldwide, but its pathogenesis remains unclear. Apoptosis or programmed cell death is thought to play a crucial role in its progression. While primarily thought to be a method for cardiomyocyte loss, provocative newer data suggest that the apoptotic cell is not inevitably committed to death. Apoptosis might be one of the meta-stable transition states, like the hibernating myocardium, that may be reversible with appropriate therapy. The cell with activated apoptotic machinery is likely to contribute to reversible systolic dysfunction while awaiting its ultimate fate. We will briefly review some of the data to support such a concept. If proven correct, this may change our future preventive and therapeutic strategies. Methods to... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1184304 Thu, 24 Jan 2008 16:57:07 +0100 1184304 http://www.medworm.com/index.php?rid=1184303&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F22222862777347j5%2F Abstract  Left ventricular assist devices (LVADs) have evolved into long-term use as destination therapy for those with severe end-stage heart failure due to other medical risks. Success with LVAD depends on adherence to a complicated mechanical regimen, and acceptance of a life that is far from normal. Patients with LVADs share characteristics with other end-stage cardiac failure patients and those waiting for or receiving heart transplants. Understanding the more thoroughly studied issues of psychiatric disorders, adherence, and behavioral correlates of success in heart failure and transplantation may identify feasible strategies for optimizing care of LVAD patients and suggest directions for future research. Depression and distress complicate post-transplant care. Psychi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1184303 Thu, 24 Jan 2008 16:57:07 +0100 1184303 http://www.medworm.com/index.php?rid=1184305&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh3104715k084wp45%2F Abstract  Hypertension is the major risk factor for coronary heart disease, stroke, and renal disease. Also, it is probably the most important risk factor for peripheral vascular disease and vascular dementia. Although hypertension occurs in both men and women, gender differences have been observed. However, whether sex hormones are responsible for the observed gender-associated differences in arterial blood pressure, and which is their mechanism of action, remains unclear. Local and circulating renin–angiotensin systems (RAS) are examples of systems that may be involved in the pathogenesis of hypertension. Classically, angiotensin II (Ang II) has been considered as the effector peptide of the RAS, but Ang II is not the only active peptide. Several of its degradation prod... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1184305 Thu, 24 Jan 2008 16:57:06 +0100 1184305 http://www.medworm.com/index.php?rid=1184302&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F960838872216m812%2F Content Type Journal ArticleDOI 10.1007/s10741-008-9080-3Authors Richard N. Kitsis, Albert Einstein College of Medicine Departments of Medicine and Cell Biology, Cardiovascular Research Center, and Cancer Center Forchheimer G46, 1300 Morris Park Avenue Bronx NY 10461 USAJagat Narula, University of California, Irvine School of Medicine Division of Cardiology 101 The City Drive, Bldg. 53, Mail Route 81, Orange Irvine CA 92868 4080 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1184302 Thu, 24 Jan 2008 16:57:06 +0100 1184302 http://www.medworm.com/index.php?rid=1145567&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl71r715r18715476%2F Abstract  From the outset, the concept of a brain renin-angiotensin system (RAS) has been controversial and this controversy continues to this day. In addition to the unresolved questions as to the means by which, and location(s) where brain Ang II is synthesized, and the uncertainties regarding the functionality of the different subtypes of Ang II receptors in the brain, a new controversy has arisen with respect to the identity of the angiotensin peptide(s) that activate brain AT1 receptors. While it has been known for some time that Ang III can activate Ang II receptors with equivalent or near-equivalent efficacy to Ang II, it has been proposed that in the brain, only Ang III is active. This proposal, which we have named “The Angiotensin III Hypothesis” states that Ang... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1145567 Fri, 11 Jan 2008 16:20:36 +0100 1145567 http://www.medworm.com/index.php?rid=1145568&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F22v16w6673w80t10%2F Abstract  A number of observations have shown that mitochondria are at the center of the pathophysiology of the failing heart and mitochondrial-based oxidative stress (OS), myocardial apoptosis, and cardiac bioenergetic dysfunction are implicated in the progression of heart failure (HF), as shown by both clinical studies and animal models. In this manuscript, we review the body of evidence that multiple defects in mitochondria are central and primary to HF progression. In addition, novel approaches to therapeutic targeting of mitochondrial bioenergetic, biogenic, and signaling abnormalities that can impact HF are discussed. Content Type Journal ArticleDOI 10.1007/s10741-007-9079-1Authors José Marín-García, The Molecular Cardiology and Neuromuscular Institute 75 Rarita... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1145568 Thu, 10 Jan 2008 16:39:44 +0100 1145568 http://www.medworm.com/index.php?rid=1139437&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc884q85v20953250%2F Abstract  The most common cause of systolic dysfunction in the United States is prior ischemic injury. As the basic functional unit of the myocardium, the cardiac myocyte is the ultimate target of both the pathogenesis and possible therapies in this paradigm. Maintaining adequate numbers of these terminally differentiated units in the myocardium has been the focus of all therapies in ischemic syndromes, including reperfusion strategies. Programmed cell death, in the forms of apoptosis, necrosis and possibly, autophagic cell death are the final arbiters of myocyte numbers following myocardial infarction. This review will focus on the evidence for cell death in the development of heart failure following myocardial infarction, a brief review of the relevant pathways and the ta... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1139437 Sun, 06 Jan 2008 14:56:56 +0100 1139437 http://www.medworm.com/index.php?rid=1139438&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Flp88v0806344800n%2F Abstract  Among the main bioactive peptides of the brain renin–angiotensin system, angiotensin (Ang) II and AngIII exhibit the same affinity for the type 1 and type 2 Ang receptors. Both peptides, injected intracerebroventricularly, cause similar increase in blood pressure (BP). Because AngII is converted in vivo to AngIII, the identity of the true effector is unknown. This review summarized recent insights into the predominant role of brain AngIII in the central control of BP underlining the fact that brain aminopeptidase A (APA), the enzyme forming central AngIII, could constitute a putative central therapeutic target for the treatment of hypertension. This led to the development of potent, systematically active APA inhibitors, such as RB150, as a prototype of a ne... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1139438 Fri, 04 Jan 2008 19:51:02 +0100 1139438 http://www.medworm.com/index.php?rid=1130640&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw2754621278m1650%2F Abstract  Cardiac myocytes die through apoptosis, oncosis, and autophagy. Apoptosis affects single cells and is morphologically characterized by nuclear fragmentation with generation of apoptotic bodies that can be seen either within dying cells or free in the interstitial spaces. Dead myocytes are removed by macrophages through phagocytosis without triggering inflammation. The circulating markers of myocyte necrosis are not increased by apoptosis. The morphologic changes of the induction and early execution phases are seen at electron microscopy while late fragmentation is visible on both light and electron microscopy. Immunoelectron microscopy provides combined functional and structural information showing cytochrome c immuno-labelling release from mitochondria, TUNEL labe... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1130640 Thu, 03 Jan 2008 16:30:20 +0100 1130640 http://www.medworm.com/index.php?rid=1117369&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F57j1041192072854%2F Content Type Journal ArticleDOI 10.1007/s10741-007-9076-4Authors John W. Wright, Stadium Way Pullman 99164-4820 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1117369 Tue, 25 Dec 2007 16:00:11 +0100 1117369 http://www.medworm.com/index.php?rid=1099890&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F16145410741qtp20%2F Abstract  Apoptosis is an evolutionarily conserved mode of cell death that is tightly regulated and critical for multicellular organism development and cellular homeostasis. Specific biochemical and morphological changes characterise cells undergoing apoptosis, and reflect the specificity in which activated apoptotic pathways follow. The two best-characterized apoptotic pathways are the extrinsic pathway and the intrinsic pathway, which involve cell surface death receptors and the mitochondria and endoplasmic reticulum respectively. Apoptotic stimuli lead to activation of either or both of these pathways, and involve sequential activation of different cysteine proteases (caspases), and in the case of the intrinsic pathway, activation of a family of Bcl-2 proteins that criti... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1099890 Sat, 15 Dec 2007 19:38:35 +0100 1099890 http://www.medworm.com/index.php?rid=1097106&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc4lx6815806107m6%2F Abstract  Apoptosis plays an important role in pathogenesis of primary and secondary cardiomyopathies. It is proposed that antiapoptotic interventions may constitute an effective strategy for these diseases. Some of the antiapoptotic interventions are “old wine in a new bottle” measures already included in the conventional pharmacotherapy. As specific antiapoptotic treatment, caspase inhibitors and anti-TNF-α antibody are in early phases of clinical trials in non-cardiac diseases or being contemplated for clinical studies. Non-pharmacotherapies such as cardiac resynchronization and left ventricular assist device also exert cardioprotection partly by antiapoptotic mechanisms. In the field of regenerative medicine, myocardial transplantation of bone marrow-derived stem c... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1097106 Fri, 14 Dec 2007 15:55:43 +0100 1097106 http://www.medworm.com/index.php?rid=1092814&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fpuql1q51q547629h%2F Abstract  Recent advances in molecular imaging have permitted the noninvasive imaging of apoptosis, a critical process underlying the pathogenesis of many diseases of the cardiovascular system including atherosclerotic vascular disease, myocardial ischemia and reperfusion injury, chronic heart failure, myocarditis, and cardiac allograft rejection. Multiple molecular targets including phosphatidylserine, phosphatidylinositol 3-kinase, and caspases have been targeted by a variety of imaging agents and modalities such as nuclear scintigraphy, PET, MRI, and fluorescent and bioluminescent imaging. Translationally, methods utilizing radiolabeled annexin V have proven promising in several clinical trials of ischemia-reperfusion injury and cardiac allograft rejection. New approache... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1092814 Wed, 12 Dec 2007 15:38:58 +0100 1092814 http://www.medworm.com/index.php?rid=1090216&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc24033j4542ht3gx%2F Abstract  Symptoms utilized in the clinical care of heart failure as markers of disease severity include, dyspnea, insomnia, low energy, fatigue, poor appetite, and diminished memory. This is despite the fact that physiologic variables such as cardiac ejection fraction and oxygen consumption do not accurately predict functional state in individuals with congestive heart failure (CHF). Distress (anxiety and depression) may amplify symptom complaints without associated physiologic aberration. Personality traits and psychiatric illness, such as mood, anxiety, and psychotic illnesses may also alter perception of somatic symptoms that are associated with this chronic illness. The impact of distress and its treatment on functional performance and CHF symptom reporting deserve add... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1090216 Tue, 11 Dec 2007 15:36:23 +0100 1090216 http://www.medworm.com/index.php?rid=1047523&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy7m648737h106200%2F Abstract  Alcohol use, abuse, and dependence have the potential to result in alcoholic cardiomyopathy (ACM). This distinct form of congestive heart failure (CHF) is responsible for 21–36% of all cases of nonischemic dilated cardiomyopathy in Western society. Without complete abstinence, the 4-year mortality for ACM approaches 50%. Therefore, accurate and detailed assessment of alcohol use in congestive heart failure is essential. The prevalence of problematic alcohol use is unrecognized by many clinicians. Clinical assessment of alcohol intake is often reduced to a simple question such as, “Do you drink?” Denial and minimization are hallmarks of alcohol abuse, with many individuals underreporting their use of alcohol. Clinicians can overcome these hurdles by implementi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1047523 Thu, 22 Nov 2007 16:31:55 +0100 1047523 http://www.medworm.com/index.php?rid=1039678&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fyg4228x384477446%2F Abstract  Exercise training is increasingly recognized as a viable treatment option for patients with heart failure (HF). For exercise to be a maximally effective treatment, it is important that patients adhere to the exercise prescription. In this review, the current state of adherence monitoring and intervention in randomized HF trials will be summarized, along with recommendations for advancing understanding of adherence in this population. Barriers to exercise participation and strategies to enhance adherence to exercise-training programs will be explored. Finally, directions for future research on exercise adherence in HF patients will be provided. Content Type Journal ArticleDOI 10.1007/s10741-007-9054-xAuthors Krista A. Barbour, Duke University Medical Center Dep... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1039678 Fri, 16 Nov 2007 16:02:19 +0100 1039678 http://www.medworm.com/index.php?rid=1039679&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp55215746v7v6115%2F Abstract  Aminopeptidase N (APN) or CD13 is a conserved type II integral membrane zinc-dependent metalloprotease in the M1 family of ectoenzymes. APN is abundant in the kidneys and central nervous system. Identified substrates include Angiotensin III (Ang III); neuropeptides, including enkephalins and endorphins; and homones, including kallidan and somatostatin. It is developmentally expressed, a myelomonocytic marker for leukemias, and a receptor for coronovirus. There is evolving support for APN in the regulation of arterial blood pressure and the pathogenesis of hypertension. In rodent strains, intracerebraventricular (i.c.v.) infusions of APN reduces, while inhibitors of APN activity have a pressor effect on blood pressure. Dysregulation of central APN has been linked t... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1039679 Fri, 16 Nov 2007 16:02:18 +0100 1039679 http://www.medworm.com/index.php?rid=1026779&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fwlg3453h3q68t405%2F Abstract  It is becoming evident that several aminopeptidases belonging to the M1 family such as aminopeptidase A (APA), placental leucine aminopeptidase (P-LAP), and adipocyte-derived leucine aminopeptidase (A-LAP) play important roles in the regulation of blood pressure under both the physiological and pathological conditions. They share HEXXH(X)18E zinc-binding and GAMEN motifs essential for enzymatic activities. In this review, the current situation regarding the biochemical characteristics of these enzymes including enzymatic properties and modes of action is summarized. Content Type Journal ArticleDOI 10.1007/s10741-007-9064-8Authors Masafumi Tsujimoto, RIKEN Laboratory of Cellular Biochemistry 2-1 Hirosawa, Wako-shi Saitama 351-0198 JapanYoshikuni Goto, RIKEN Labor... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1026779 Tue, 13 Nov 2007 16:16:36 +0100 1026779 http://www.medworm.com/index.php?rid=1017048&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F156u768345jl7007%2F Abstract  For decades, angiotensin (Ang) II was considered as the end product and the only bioactive peptide of the renin–angiotensin system (RAS). However, later studies revealed biological activity for other Ang fragments. Amongst those, Ang IV has drawn a lot of attention since it exerts a wide range of central and peripheral effects including the ability to enhance learning and memory recall, anticonvulsant and anti-epileptogenic properties, protection against cerebral ischemia, activity at the vascular level and an involvement in atherogenesis. Some of these effects are AT1 receptor dependent but others most likely result from the binding of Ang IV to insulin-regulated aminopeptidase (IRAP) although the exact mechanism(s) of action that mediate the Ang IV-induced effe... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1017048 Thu, 08 Nov 2007 16:09:59 +0100 1017048 http://www.medworm.com/index.php?rid=1017047&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9164w50326mqx141%2F Abstract  The renin-angiotensin system (RAS) plays an important role in the maintenance of normal blood pressure and the etiology of hypertension; however, minimal attention has been paid to the degradation of the effector peptide, angiotensin II (AngII). Since aminopeptidase A (APA)-deficient mice develop hypertension APA appears to be an essential enzyme in the control of blood pressure via degradation of AngII. The robust hypertension seen in the spontaneously hypertensive rat (SHR) is due to activation of the RAS, and an accompanying decrease in kidney APA. Changes in APA have also been measured during the activation of the RAS in the Goldblatt hypertension model and Dahl salt-sensitive (DSS) rat. The DSS rat shows an elevation in renal APA activity at the onset of hype... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1017047 Thu, 08 Nov 2007 16:09:59 +0100 1017047 http://www.medworm.com/index.php?rid=1017050&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5q2r14r5612j1m30%2F Abstract  A hallmark symptom of heart failure (HF) is exercise intolerance, typically evidenced by excessive shortness of breath, and/or fatigue with exertion. In recent years, the physiologic response to progressive exercise using direct measures of ventilation and gas exchange, commonly termed the cardiopulmonary exercise test (CPX), has evolved into an important clinical tool in the management of patients with HF. There is currently debate regarding the optimal CPX response to apply when stratifying risk for mortality, hospitalization, or other outcomes in patients with HF. Early studies in this area focused on the application of peak VO2 in predicting outcomes in patients considered for transplantation. More recently, the focus of these studies has shifted to an emphasi... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1017050 Wed, 07 Nov 2007 15:22:57 +0100 1017050 http://www.medworm.com/index.php?rid=1017049&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv0t7j72601024v28%2F Abstract  The renin-angiotensin-aldosterone system (RAAS) is critical in regulating systemic blood pressure, water and electrolyte balance, and pituitary gland hormones. These physiologies appear to be primarily mediated by the angiotensin II/AT1 receptor subtype system. Overstimulation of this system can predispose cardiovascular disease (CVD) characterized by excessive vasoconstriction, fibrosis, and cardiac remodeling. If untreated, the patient typically displays a continuum of pathophysiologic conditions progressing from atherosclerosis to left ventricle hypertrophy (LVH), coronary thrombosis, myocardial infarcts, with heart failure as an endpoint. Intervention with antihypertensive therapy is necessary to inhibit this progression. RAAS blocking drugs appear to be the mo... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=1017049 Wed, 07 Nov 2007 15:22:57 +0100 1017049 http://www.medworm.com/index.php?rid=981885&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy1273605301602h6%2F This article reviews the effects of exercise training on clinical outcomes and addressing the safety of exercise training and the indications for training in HF patients. Content Type Journal ArticleDOI 10.1007/s10741-007-9052-zAuthors Robert S. McKelvie, Hamilton Health Sciences Corporation – General Site 237 Barton Street East L8L 2X2 Hamilton ON Canada Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=981885 Thu, 25 Oct 2007 15:07:03 +0100 981885 http://www.medworm.com/index.php?rid=978854&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F33461k825888175u%2F Abstract   The pathophysiology of chronic heart failure (CHF) is typically conceptualized in terms of cardiac dysfunction. However, alterations in peripheral blood flow and intrinsic skeletal muscle properties are also now recognized as mechanisms for exercise intolerance that can be modified by therapeutic exercise. This overview focuses on blood delivery, oxygen extraction and utilization that result from heart failure. Related features of inflammation, changes in skeletal muscle signaling pathways, and vulnerability to skeletal muscle atrophy are discussed. Specific focus is given to the ways in which perfusion and skeletal muscle properties affect exercise intolerance and how peripheral improvements following exercise training increase aerobic capacity. We also ide... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=978854 Tue, 23 Oct 2007 14:39:33 +0100 978854 http://www.medworm.com/index.php?rid=978853&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb2140437w433j334%2F Abstract  Heart failure is common, and depression is common in heart failure patients, adding substantially to the burden of the disease. There is some evidence for the safe and at least modestly effective use of psychotherapy and antidepressants to treat depression in heart failure patients. Cognitive behavioral psychotherapy and selective serotonin reuptake inhibitors are first line treatments. The efficacy of depression treatment in altering cardiac outcomes in heart failure patients has yet to be established. Content Type Journal ArticleDOI 10.1007/s10741-007-9058-6Authors Peter A. Shapiro, New York Presbyterian Hospital-Columbia University Medical Center, Columbia University Department of Psychiatry 622 W. 168 St. Box 427 New York NY 10032 USA Journal Heart Fa... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=978853 Tue, 23 Oct 2007 14:39:32 +0100 978853 http://www.medworm.com/index.php?rid=958655&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F01v633g54022nk25%2F Abstract  Chronic heart failure (CHF) is a common and debilitating condition characterized by reduced exercise tolerance. While exercise training was once thought to be contraindicated for patients with CHF, a substantial body of data has been published over the last two decades to support the use of exercise programs for these patients. Improvements in exercise capacity, quality of life, and mortality have been demonstrated among patients with CHF who have participated in formal exercise programs. Exercise prescription is a means of assessing and interpreting clinical information and applying the principles of training to develop an appropriate regimen so that these benefits are achieved. The major principles of the exercise prescription are the mode, frequency, duration, an... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=958655 Tue, 16 Oct 2007 15:38:31 +0100 958655 http://www.medworm.com/index.php?rid=951849&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp2714h086424q593%2F Abstract  In chronic heart failure patients, the increase of peak VO2 observed after a period of aerobic training is currently attributed more to peripheral (skeletal muscle) than central (heart) adaptations. This paper reviews the current scientific evidence regarding the existence or the absence of significant training-induced adaptations of peak cardiac output and its determinants in patients with chronic heart failure due to left ventricular systolic dysfunction. It is concluded that, on the basis of available literature, a training-induced significant increase of peak cardiac output with respect to pre-training values does exist in the chronic heart failure population. Such an effect is due to adaptations of the main cardiac output determinants, that is, heart rate and ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=951849 Fri, 12 Oct 2007 17:54:59 +0100 951849 http://www.medworm.com/index.php?rid=951848&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F71101813x7245334%2F This article presents evidence that improvement of skeletal muscle phenotype (muscle mass, fiber morphology, and histochemistry) should be a fundamental goal of rehabilitation in patients with CHF. Moreover, RT may be the preferred exercise modality when targeting the periphery for muscle phenotype adaptation. Content Type Journal ArticleDOI 10.1007/s10741-007-9055-9Authors Randy W. Braith, University of Florida Center for Exercise Science, College of Health and Human Performance and the College of Medicine P.O. Box 118206 Gainesville FL 32611 USADarren T. Beck, University of Florida Center for Exercise Science, College of Health and Human Performance and the College of Medicine P.O. Box 118206 Gainesville FL 32611 USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print I... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=951848 Fri, 12 Oct 2007 17:54:59 +0100 951848 http://www.medworm.com/index.php?rid=951847&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff475826k41903u23%2F Abstract  Although neurohumoral excitation is the hallmark of heart failure (HF), the mechanisms underlying this alteration are not entirely known. Abnormalities in several systems contribute to neurohumoral excitation in HF, including arterial and cardiopulmonary baroreceptors, central and peripheral chemoreceptors, cardiac chemoreceptors, and central nervous system abnormalities. Exercise intolerance is characteristic of chronic HF, and growing evidence strongly suggests that exercise limitation in patients with chronic HF is not due to elevated filling pressures or inadequate cardiac output during exercise, but instead due to skeletal myopathy. Several lines of evidence suggest that sympathetic excitation contributes to the skeletal myopathy of HF, since sympathetic acti... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=951847 Fri, 12 Oct 2007 17:54:59 +0100 951847 http://www.medworm.com/index.php?rid=938494&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa873111q54743215%2F Abstract  Cardiologists now recognize that the cardio-centric model of heart failure does not sufficiently explain the entire traits particular to chronic heart failure. Evidence accumulates, that many features of the syndrome can be explained by the known biological effects of inflammatory mediators. Indeed, when expressed in experimental models at concentrations commonly observed in heart failure, inflammatory mediators such as tumor necrosis factor-α, interleukin-6, and nitric oxide can produce effects that mimic features of heart failure, including (but not limited to) progressive left-ventricular dysfunction, pulmonary edema, left-ventricular remodeling, and cardiomyopathy. As we witness anti-cytokine therapies and other strategies to avoid an increase in cytokines we... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=938494 Sat, 06 Oct 2007 17:41:31 +0100 938494 http://www.medworm.com/index.php?rid=932484&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr543g3587628n427%2F Content Type Journal ArticleDOI 10.1007/s10741-007-9049-7Authors Steven J. Keteyian, Henry Ford Hospital Division of Cardiovascular Medicine 6525 Second Avenue Detroit MI 48202 USAWilliam E. Kraus, Duke University Medical Center Division of Cardiovascular Medicine Durham NC USA Journal Heart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=932484 Fri, 05 Oct 2007 15:57:58 +0100 932484 http://www.medworm.com/index.php?rid=799917&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp52014r5k7855046%2F Abstract  Chronic heart failure (HF) represents an emerging epidemic since its prevalence is continuously increasing despite advances in treatment. Many recent clinical studies have clearly demonstrated that statin therapy is associated with improved outcomes in HF irrespective of aetiology (ischaemic or not) or baseline cholesterol levels. Indeed, most of the conducted large statin trials and trials in HF have demonstrated a positive effect of statins in HF patients. Furthermore, the use of statins in HF seems to be safe as none of the recent trials has resulted in worse outcomes for HF patients treated with statins. Potential mechanisms through which statins could benefit the failing myocardium include non-sterol effects of statins, as well as effects on nitric oxide and ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=799917 Mon, 13 Aug 2007 21:49:50 +0100 799917 http://www.medworm.com/index.php?rid=774003&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc366l14kj585t2rg%2F Abstract  In the past few years, the dogma that the heart is a terminally differentiated organ has been challenged. Evidence from preclinical investigations emerged that there are cells, even in the heart itself, that may be able to restore impaired cardiac function after myocardial infarction. Although the exact mechanisms by which the infarcted heart can be repaired by stem cells are not yet fully defined, there is a new optimism among cardiologists that this treatment will prove successful in addressing the cause of heart failure after myocardial infarction—myocyte loss. Despite the promising preliminary data of human myocardial stem cell trials, scientists have also focused on the possibility of enhancing the underlying mechanisms of stem cell repair to gain healthier... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=774003 Wed, 01 Aug 2007 06:54:14 +0100 774003 http://www.medworm.com/index.php?rid=774002&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F435w6tm73m741h5m%2F Abstract  Objective and validated measures of depression/distress (anxiety and anger) are available and readily usable at the bedside or in clinic. Foremost among these is the Patient’s Health Questionnaire—an adaptation of DSM IV criteria for Major Depressive Disorder that permits administration and scoring by nursing or physician personnel, and quantification of the intensity of depression. A score of 10 or greater indicates a need for evaluation/treatment. Because of patient denial/minimization/alexithymia, PHQ negatives should undergo further screening by having a spouse or friend complete a depression/distress rating scale. The only standardized, normed, and validated spouse/friend scale presently available is the Ketterer Stress Symptom Frequency Checklist, which ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=774002 Wed, 01 Aug 2007 06:54:13 +0100 774002 http://www.medworm.com/index.php?rid=724595&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy454432099814450%2F Content TypeJournal Article JournalHeart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=724595 Sat, 07 Jul 2007 11:13:09 +0100 724595 http://www.medworm.com/index.php?rid=671237&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw751h6275613v0r1%2F Abstract  Increasing evidence suggests that High-density lipoproteins (HDL) are a direct cardioprotective agent in the setting of acute myocardial ischemia/reperfusion injury, and that this cardioprotection occurs independently of their atheroprotective effect. Studies on the involved mechanisms have revealed that the biologically active HDL-compound sphingosine-1-phosphate (S1P) is responsible for the beneficial effect of HDL on the myocardium. There appears to be an intricate interplay between known preconditioning agents and components of the S1P synthesis machinery in the heart, which makes S1P signalling an attractive downstream convergence point of preconditioning and cardioprotection at the level of its G protein-coupled receptors. While local S1P production has been... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=671237 Thu, 07 Jun 2007 07:49:47 +0100 671237 http://www.medworm.com/index.php?rid=654154&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh81p18808t477836%2F Abstract  Myocardial protection aims at preventing myocardial tissue loss: (a) In the acute stage, i.e., during primary angioplasty in acute myocardial infarction. In this setup, the attenuation of reperfusion injury is the main target. As a “mechanical” means, post-conditioning has already been tried in man with encouraging results. Pharmacologic interventions that could be of promise are statins, insulin, peptide hormones, including erythropoietin, fibroblast growth factor, and many others. (b) The patient with chronic coronary artery disease offers another paradigm, with the target of avoidance of further myocyte loss through apoptosis and inflammation. Various pharmacologic agents may prove useful in this context, together with exercise and “mechanical” improvem... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=654154 Fri, 01 Jun 2007 13:50:45 +0100 654154 http://www.medworm.com/index.php?rid=654156&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F91671m10567518l3%2F Abstract  There is little doubt that the discovery of ischemic preconditioning (PC) has been one of the fundamental milestones in the field of ischemic biology in the past 20 years. The purpose of this article is to review the pathophysiology and molecular basis of the late phase of myocardial PC. The exploitation of late PC for the development of novel gene therapy strategies aimed at inducing a permanently preconditioned cardiac phenotype (prophylactic cardioprotection) will also be discussed. Deciphering the mechanism of late PC has not only conceptual interest but also a considerable therapeutic implications, since transfer of the genes that underlie late PC would be expected to replicate the salubrious effects of this response of the heart to stress. Content Ty... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=654156 Fri, 01 Jun 2007 13:50:43 +0100 654156 http://www.medworm.com/index.php?rid=654157&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F128156jj94u28h93%2F This article reviews the origins and evolution of the RISK pathway, as part of a potential common cardioprotective pathway, which can be activated by an ever-expanding list of agents administered at the time of myocardial reperfusion, as well as by IPC and IPost. Preliminary clinical studies have demonstrated myocardial protection with several of these pharmacological activators of the RISK pathway in AMI patients undergoing PCI. Through the use of appropriately designed clinical trials, guided by the wealth of existing preclinical data, the administration of pharmacological agents which are known to activate the RISK pathway, when applied as adjuvant therapy to current myocardial reperfusion strategies for patients presenting with an AMI, should lead to improved clinical outcomes in... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=654157 Fri, 01 Jun 2007 13:50:41 +0100 654157 http://www.medworm.com/index.php?rid=654155&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq610500kk01710m5%2F Abstract  Although myocardial ischemia was once thought to result in irreversible cellular damage, it is now demonstrated that in cardiac tissue, submitted to the stress of oxygen and substrate deprivation, endogenous mechanisms of cell survival may be activated. These molecular mechanisms result in physiological conditions of adaptation to ischemia, known as myocardial stunning and hibernation. These conditions result from a switch in gene and protein expression, which sustains cardiac cell survival in a context of oxygen deprivation and during the stress of reperfusion. The pattern of cell survival elicited by ischemia in myocardial stunning or hibernation results in the activation of cytoprotective mechanisms that will protect the heart against further ischemic damage, a... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=654155 Fri, 01 Jun 2007 13:50:40 +0100 654155 http://www.medworm.com/index.php?rid=654158&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg26p011133552km7%2F Abstract  Heart Failure is the only cardiovascular disease diagnosis increasing in prevalence in the United States. Currently there are more than 5 million people diagnosed with heart failure in the United States and that population is increasing exponentially. Clinical trials in advanced pharmacological therapies have shown a significant value in reducing the morbidity and mortality of the disease process. Nevertheless, many patients who are optimally treated with drug therapy continue to progress from asymptomatic left ventricular dysfunction to symptomatic and then end-stage heart failure. Beyond drug therapy, devices have begun to make a significant impact on symptoms and clinical outcomes in patients, particularly those with more advanced forms of heart failure. N... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=654158 Fri, 01 Jun 2007 13:50:37 +0100 654158 http://www.medworm.com/index.php?rid=643989&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb356678q6n2g1825%2F Abstract  Cardiomyocyte death secondary to transient ischemia occurs mainly during the first minutes of reperfusion, in the form of contraction band necrosis involving sarcolemmal rupture. Cardiomyocyte hypercontracture caused by re-energisation and pH recovery in the presence of impaired cytosolic Ca2+ control as well as calpain-mediated cytoskeletal fragility play prominent roles in this type of cell death. Hypercontracture can propagate to adjacent cells through gap junctions. More recently, opening of the mitochondrial permeability transition pore has been shown to participate in reperfusion-induced necrosis, although its precise relation with hypercontracture has not been established. Experimental studies have convincingly demonstrated that infarct size can be markedly ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=643989 Sat, 26 May 2007 15:05:14 +0100 643989 http://www.medworm.com/index.php?rid=636256&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl4260w4r54427147%2F Abstract  Acute myocardial infarction is the leading cause of morbidity and mortality in industrialized countries. Ischemic postconditioning, that consists of repeated brief episodes of ischemia-reperfusion performed just after reflow following a prolonged ischemic insult, dramatically reduces infarct size in animal models. Recent data indicate that it might involve the activation of the PI3-kinase—Akt—eNOS as well as PKC signalling pathways and inhibition of the opening of the permeability transition pore. A recent clinical study demonstrated that postconditioning protects the human heart. Repeated brief episodes of inflation-deflation of the angioplasty balloon performed immediately after re-opening of the culprit coronary artery reduced infarct size by 36%. Additiona... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636256 Thu, 24 May 2007 08:10:47 +0100 636256 http://www.medworm.com/index.php?rid=636257&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F03620112p1j74r54%2F Abstract  Infarct size is determined not only by the duration and severity of ischemia, but also by pathological processes initiated at reperfusion (reperfusion injury). Numerous pharmacological strategies have been reported which administer drugs at or just before the onset of reperfusion, with subsequent salubrious effects, notably a reduction in infarct size. However, few if any of these strategies have become standard of care in the catheterization laboratory setting. Postconditioning, defined as repeated brief cycles of reperfusion interrupted by ischemia (or hypoxia) applied at the onset of reperfusion, was recently introduced as a mechanical strategy to attenuate reperfusion injury. Postconditioning intervenes only during the first few minutes of reperfusion. However... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636257 Wed, 23 May 2007 07:42:44 +0100 636257 http://www.medworm.com/index.php?rid=636261&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk14n74k6ut060158%2F Abstract  Major factors linking mitochondrial dysfunction with myocardial injury are analyzed along with protective mechanisms elicited by endogenous processes and pharmacological treatments. In particular, a reduced rate of ATP hydrolysis and a slight increase in ROS formation appear to represent the prevailing components of self-defense mechanisms, especially in the case of ischemic preconditioning. These protective processes are activated by signaling pathways, which converge on mitochondria activating the mitochondrial KATP channels and/or inhibiting the mitochondrial permeability transition pore. These pathways can also be stimulated by pharmacological treatments. Another major goal for cardioprotection is decreasing the burst in mitochondrial ROS formation that charact... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636261 Tue, 22 May 2007 10:10:16 +0100 636261 http://www.medworm.com/index.php?rid=636263&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb3225602qk658h60%2F Abstract  Boosting myocardial resistance to acute as well as chronic ischemic damage would ameliorate the detrimental effects of numerous cardiac pathologies and reduce the probability of transition to heart failure. Experimental cardiology has pointed to ischemic and pharmacological pre- as well as post-conditioning as potent acute cardioprotective manipulations. Additional exciting experimental strategies include the induction of true regenerative and/or angiogenic responses to the damaged heart, resulting in sustained structural and functional beneficial effects. Fibroblast growth factor-2 (FGF-2), an endogenous multifunctional protein with strong affinity for the extracellular matrix and basal lamina and well-documented paracrine, autocrine and intacellular modes of act... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636263 Tue, 22 May 2007 10:10:14 +0100 636263 http://www.medworm.com/index.php?rid=636260&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F370667560j77778l%2F Abstract  Connexin 43 (Cx43) is the predominant protein forming gap junctions and non-junctional hemichannels in ventricular myocardium, but Cx43 is also localized at the inner membrane of cardiomyocyte mitochondria. In cardiomyocytes, Cx43 is involved in the formation of reactive oxygen species, which are central to the signal transduction cascade of ischemic preconditioning’s protection. Accordingly, genetically-induced or age-related loss of Cx43 abolishes infarct size reduction by ischemic preconditioning. Similarly, mitochondrial import inhibition of Cx43 completely blocks infarct size reduction by pharmacological preconditioning with diazoxide. In contrast to its importance for preconditioning-induced cardioprotection, Cx43 is not important for infarct size reductio... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636260 Tue, 22 May 2007 10:10:12 +0100 636260 http://www.medworm.com/index.php?rid=636264&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft68736u451038377%2F Abstract  Myocardial ischemia and reperfusion injury have been extensively investigated in the laboratory mainly in healthy tissues. However, in clinical settings, ischemic heart disease coexists with certain illnesses, which could potentially influence the response of the myocardium to ischemia and reperfusion. Recent research has revealed that the abnormal heart may not be always vulnerable to ischemic injury. Furthermore, the effect of powerful means of protection, such as ischemic preconditioning, may not be in operation under certain pathological conditions. With this evidence in mind, the present review will focus on the response of the abnormal heart to ischemia and reperfusion, the possible underlying mechanisms, and potential cardioprotective strategies. Content... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636264 Tue, 22 May 2007 10:10:10 +0100 636264 http://www.medworm.com/index.php?rid=636258&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fjn12v704720711v4%2F Abstract  A common feature of the hemodynamically or metabolically stressed heart is the return to a pattern of fetal metabolism. A hallmark of fetal metabolism is the predominance of carbohydrates as substrates for energy provision in a relatively hypoxic environment. When the normal heart is exposed to an oxygen rich environment after birth, energy substrate metabolism is rapidly switched to oxidation of fatty acids. This switch goes along with the expression of “adult” isoforms of metabolic enzymes and other proteins. However, the heart retains the ability to return to the “fetal” gene program. Specifically, the fetal gene program is predominant in a variety of pathophysiologic conditions including hypoxia, ischemia, hypertrophy, and atrophy. A common feature of ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636258 Tue, 22 May 2007 10:10:07 +0100 636258 http://www.medworm.com/index.php?rid=636259&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa6n1r2t008n273j6%2F Abstract  Ischemic preconditioning renders the heart resistant to infarction from ischemia/reperfusion. Over the past two decades a great deal has been learned about preconditioning’s mechanism. Adenosine, bradykinin, and opioids act in parallel to trigger the preconditioned state and do so by activating PKC. While adenosine couples directly to PKC through the phospholipases, bradykinin and opioids do so through a complex pathway that includes in order: phosphatidylinositol 3-kinase (PI3-kinase), Akt, nitric oxide synthase, guanylyl cyclase, PKG, opening of mitochondrial KATP channels, and activation of PKC by redox signaling. There are even differences between the opioid and bradykinin coupling as the former activates PI3-kinase through transactivation of the epidermal gr... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636259 Tue, 22 May 2007 10:10:04 +0100 636259 http://www.medworm.com/index.php?rid=636262&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2420p46q57162724%2F Abstract  The myocardium represents a major source of several families of peptide hormones under normal physiological conditions and the plasma concentrations of many of these “cardiac peptides” (or related pro-peptide fragments) are substantially augmented in many cardiac disease states. In addition to well-characterised endocrine functions of several of the cardiac peptides, pleiotropic functions within the myocardium and the coronary vasculature represent a significant aspect of their actions in health and disease. Here, we focus specifically on the cardioprotective roles of four major peptide families in myocardial ischemia and reperfusion: adrenomedullin, kinins, natriuretic peptides and the urocortins. The patterns of early release of all these peptides are consis... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=636262 Tue, 22 May 2007 10:10:02 +0100 636262 http://www.medworm.com/index.php?rid=622148&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp63l107w248375v1%2F Content TypeJournal Article JournalHeart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=622148 Thu, 17 May 2007 07:30:19 +0100 622148 http://www.medworm.com/index.php?rid=622146&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff7tj4q316334717h%2F Abstract  A number of epidemiological and animal studies have suggested a cardioprotective role for estrogen. This review will focus on the cardioprotective role of estrogen in ischemia-reperfusion injury. Estrogen binding to receptors can lead to altered gene expression and estrogen has been shown to induce expression of a number of genes that have been suggested to be important in cardioprotection. Estrogen is reported to increase expression of the plasma membrane glucose transporter GLUT4 and to increase carbohydrate metabolism. Estrogen has also been reported to increase mitochondrial biogenesis and to alter mitochondrial generation of reactive oxygen species. Estrogen results in upregulation of cardiac eNOS and nNOS, which have been shown previously to be important med... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=622146 Thu, 17 May 2007 07:30:17 +0100 622146 http://www.medworm.com/index.php?rid=622147&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F78k181q08l05483p%2F Abstract  Brief ischemia to the myocardium initiates a cascade of biochemical events in cardiac myocytes that protects the heart muscle during subsequent ischemic insults. This phenomenon is called ischemic preconditioning. If an acute myocardial infarction is preceded by preinfarction angina, it results in smaller infarction size, fewer cardiac arrhythmias, and better-left ventricular function. During coronary intervention, brief balloon inflation protects the heart during subsequent inflations. Patients vary in the degree of preconditioning and those patients who have the ability to demonstrate a significant preconditioning effect will have lesser incidence of subsequent cardiac events. Preconditioning protects the myocardium during coronary artery bypass surgery, particu... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=622147 Thu, 17 May 2007 07:30:15 +0100 622147 http://www.medworm.com/index.php?rid=609275&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ffuw3175qt2603n56%2F Abstract  Non-invasive ventilation (NIV) refers to the delivery of mechanical ventilation to the lungs using techniques that do not require an endotracheal airway. Essentially, there are two modalities: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV). In acute pulmonary edema (APE) both modalities have shown a faster improvement in gas exchange and physiologic parameters with respect to conventional oxygen therapy. CPAP is a simple technique that may reduce preload and afterload, increasing cardiac output in some patients. It has been successfully used in APE in the last 30 years, demonstrating a reduction in the intubation rate and mortality. The most common level of pressure is 10 cmH2O. NIPSV is a more complex mode t... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=609275 Thu, 10 May 2007 07:12:48 +0100 609275 http://www.medworm.com/index.php?rid=609277&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc8w50404555v7377%2F Abstract  Acute heart failure syndromes (AHFS) represent the most common discharge diagnosis in patients over age 65 years, with an exceptionally high mortality and readmission rates at 60–90 days. Recent surveys and registries have generated important information concerning the clinical characteristics of patients with AHFS and their prognosis. Most patients with AHFS present either with normal systolic blood pressure or elevated blood pressure. Patients who present with elevated systolic blood pressure usually have pulmonary congestion, a relatively preserved left ventricular ejection fraction (LVEF), are often elderly women, and their symptoms develop typically and abruptly. Patients with normal systolic blood pressure present with systemic congestion, reduce... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=609277 Wed, 09 May 2007 14:29:58 +0100 609277 http://www.medworm.com/index.php?rid=609276&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F472321264g8686m5%2F Abstract  Acute heat failure syndromes are a heterogenous group of conditions. Chronic heart failure exacerbations represent the vast majority of cases. Pathophysiologic mechanisms, such as hypotension with peripheral tissue hypoperfusion, renal function impairment and myocardial ischemia and injury, adversely affect patients’ clinical outcome. Classical inotropes, such as beta-agonists (dobutamine, dopamine) and phosphodiesterase inhibitors (milrinone), seem to improve clinical symptoms and hemodynamics of acutely decompensated chronic heat failure patients, but they have been associated with increased long-term mortality. Thus, on the basis of the available evidence, these agents can be used only as a temporary treatment of acute heart failure exacerbations with stringe... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=609276 Wed, 09 May 2007 14:29:55 +0100 609276 http://www.medworm.com/index.php?rid=609278&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj27387875vv28u40%2F Abstract  Non-adherence with medical regimens in heart failure is a significant challenge and serves as a major reason that favorable outcomes associated with various therapies evaluated in clinical trials have not translated to the so-called real-world setting. Non-adherence has complex influences and is clearly associated with poorer outcomes. The approaches that are used or have been proposed to improve drug-taking behavior, such as in-hospital initiation of therapy, simplification of dosing regimens through adoption of combination and long-acting formulations, and improvements in provider–patient communication, are reviewed. Content TypeJournal Article JournalHeart Failure ReviewsOnline ISSN 1573-7322Print ISSN 1382-4147 (Source: Heart Failure Reviews) Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=609278 Fri, 04 May 2007 09:02:25 +0100 609278 http://www.medworm.com/index.php?rid=571144&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj64j6p3j64575638%2F Abstract  Many of the disorders and lesions leading to acute heart failure can be treated surgically. Modern surgical techniques like the off pump coronary surgery, newer techniques for the surgical treatment of the mechanical complications of acute MI and valvular reparative techniques have been added to the surgical armamentarium in recent years. Modern ventricular assist devices have started their career in the clinical arena promising to be less invasive. At the same time the spectrum of indications for mechanical circulatory support continues to witness a rapid expansion. Technical advances have led to an evolution of surgical strategies. Heart failure surgery is now in a position to offer improved outcomes, avoidance of recurrence of acute heart failure or the develop... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=571144 Tue, 24 Apr 2007 06:58:44 +0100 571144 http://www.medworm.com/index.php?rid=571145&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fkt4037q86128l485%2F Abstract  Systolic heart failure (HF) is a progressive disorder that often begins with asymptomatic left ventricular (LV) systolic dysfunction and culminates in symptoms from fluid overload and poor end-organ perfusion. The progression to symptomatic HF is accompanied by marked activation of neurohormonal and cytokine systems, as well as a series of adaptive LV anatomical and functional changes, collectively referred to as LV remodelling. However, the mechanisms underlying symptom appearance have not been delineated and the weight of experimental and clinical evidence suggests that the development of symptomatic HF occurs independently of the haemodynamic status of the patient. The left atrium is a muscular chamber strategically located between the left ventricle and the pu... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=571145 Sat, 21 Apr 2007 07:08:51 +0100 571145 http://www.medworm.com/index.php?rid=571146&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb0505gx5t3k2203n%2F Abstract  Acute Heart Failure is a heterogeneous set of syndromes associated with significant morbidity and mortality. There are several classifications of acute heart failure syndromes (AHFS) based on pathophysiology or clinical presentation. In the USA and in Europe, AHFS are the first cause of hospitalization of the elderly, and the leading health care cost. Despite this clinical and social importance, AHFS have received little attention from clinicians and researchers. Recently published epidemiological studies described clinical presentation, characteristics and treatment of over 100,000 patients hospitalized with AHFS. These studies also underlined the poor, short, and medium term prognosis, especially for the most severe patients admitted to an intensive care unit, w... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=571146 Sat, 21 Apr 2007 07:08:50 +0100 571146 http://www.medworm.com/index.php?rid=571148&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F76j5kn2n161t117t%2F Abstract  Most patients with acute heart failure present with increased left ventricular filling pressure and high or normal blood pressure; only a minority present with cardiogenic shock. In this context, therapy with vasodilators in the acute setting can improve both hemodynamics and symptoms. Vasodilators are usually given in conjunction with diuretics, although much of the acute effect of loop diuretics may be due to venodilation. Currently available agents include nitroglycerin, nitroprusside, and nesiritide. Nitroglycerin relieves pulmonary congestion primarily through direct venodilation, but may dilate coronary arteries and increase collateral blood flow at higher doses, an effect desirable in patients with ischemia. Tachyphylaxis may develop, necessitating incremen... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=571148 Fri, 20 Apr 2007 07:09:30 +0100 571148 http://www.medworm.com/index.php?rid=571147&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx8652567n541650q%2F Abstract  Electrical devices, Cardiac Resynchronization Therapy (CRT) pacemakers, the Implantable Cardiac Defibrillator (ICD) and a combination of both, constitute an important line of treatment in the therapy of moderate to severe chronic heart failure. The effectiveness of these devices in the treatment of acute decompensated heart failure has yet to be systematically evaluated. However, the beneficial clinical effects of CRT translate into a marked reduction of heart failure-related hospitalization. Devices also offer unique diagnostic applications by continuous measurement of clinically useful physiological parameters over time. Of particular interest, monitoring of intrathoracic impedance and right ventricular pressures allows to detect changes in volume load in an ear... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=571147 Fri, 20 Apr 2007 07:09:30 +0100 571147 http://www.medworm.com/index.php?rid=571150&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn410w764r3451243%2F Abstract  Diuretics have been a mainstay for the treatment of acute decompensated heart failure (ADHF) for the past four decades, though their short-term gains have been questioned recently given their potential long-term deleterious systemic effects. The methods of diuretic administration as well as the optimal dosing regimen of these agents are both areas that have been increasingly coming under scrutiny. The lack of rigorous clinical trials examining diuretic use in ADHF, however, has led to a general adoption of non-evidence based treatment algorithms for this patient population. Though the use of intravenous vasodilators for the treatment of decompensated heart failure has grown tremendously over the last few years, the fact remains that diuretics are still indispensab... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=571150 Fri, 20 Apr 2007 07:09:29 +0100 571150 http://www.medworm.com/index.php?rid=571149&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe53473g8x7h604vn%2F Abstract  Acute Heart Failure is a major cause of hospitalisation, with a rate of death and complications. New guidelines have been developed in order to diagnose and treat this disease. Despite these efforts pathophysiology and treatments options are still limited. There is agreement among the experts that increasing the cardiac output and the stroke volume without fluid overloading the patient should be the goal of every treatment. Despite this, there is no agreement on how to monitor the cardiac function and how to follow it after a therapeutic intervention. In other fields of critical care cardiovascular monitoring and application of early goal directed protocols showed benefits. This review explores the available possibilities of how to monitor the cardiac function in ... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=571149 Fri, 20 Apr 2007 07:09:29 +0100 571149 http://www.medworm.com/index.php?rid=554714&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy5552j86847u2x2w%2F Abstract  As for other critically ill diseases, two key factors may markedly improved morbidity and mortality of acute heart failure syndromes (AHFS): early initiation of treatment and tailored therapy. Early initiation aims to stop the negative cascade of heart dysfunction. Tailored therapy should be based on the level of systolic blood pressure at admission and fluid retention. Indeed, EFICA and OPTIMIZE-HF showed that patients with high systolic blood pressure have a left ventricular systolic function that is likely preserved and those with low systolic blood pressure have a lower left ventricular ejection fraction and frequent signs of organ’s hypoperfusion. Among the proposed treatments, non-invasive ventilation is the only treatment that was consistently proven to b... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=554714 Wed, 18 Apr 2007 14:17:01 +0100 554714 http://www.medworm.com/index.php?rid=554715&cid=s_33396_7_f&fid=33396&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp855171614m80772%2F Abstract  Since the discovery of atrial natriuretic factor by de Bold et al., there has been tremendous progress in our understanding of the physiologic, diagnostic and therapeutic roles of the natriuretic peptides (NPs) in health and disease. Natriuretic peptides are endogenous hormones that are released by the heart in response to myocardial stretch and overload. Three mammalian NPs have been identified and characterized, including atrial natriuretic peptide (ANP or atrial natriuretic factor), B-type natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). In addition, Dendroaspis natriuretic peptide (DNP) has been isolated from the venom of Dendroaspis angusticeps (the green mamba snake), and urodilatin from human urine. These peptides are structurally similar... Heart Failure Reviews journals http://www.medworm.com/rss/comments.php?id=554715 Wed, 18 Apr 2007 14:16:59 +0100 554715